NPI | 1053935825 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: 1172000) |
Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: DE 1172000) |
Enumeration Date | 2020-06-07 |
Last Update Date | 2021-02-22 |