NPI | 1043649197 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367H00000X Anesthesiologist Assistant (Licence: FL AA452) |
Additional Taxonomies | 367H00000X Anesthesiologist Assistant |
367H00000X Anesthesiologist Assistant (Licence: DC AA000092) | |
Enumeration Date | 2013-11-08 |
Last Update Date | 2018-08-16 |