NPI | 1063756708 |
---|---|
Former Name | JOJIN ANGELO JOSE |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: OK 2360) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: AZ 5311) |
Enumeration Date | 2012-11-19 |
Last Update Date | 2014-05-09 |