NPI | 1033268834 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 246ZC0007X Specialist/Technologist, Other, Surgical Assistant |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical |
Enumeration Date | 2007-01-09 |
Last Update Date | 2024-11-20 |