NPI | 1093753709 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 3363) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AZ 3363) |
Enumeration Date | 2006-06-03 |
Last Update Date | 2015-02-02 |