NPI | 1053847863 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: TN 3233) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: TN 3233) |
Enumeration Date | 2017-05-11 |
Last Update Date | 2020-07-28 |