NPI | 1023242526 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367H00000X Anesthesiologist Assistant (Licence: TX 1025) |
Additional Taxonomies | 367H00000X Anesthesiologist Assistant (Licence: FL 1025) |
Enumeration Date | 2009-05-12 |
Last Update Date | 2020-08-18 |