NPI | 1144469552 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: GA 005529) |
Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: GA 5529) |
363AM0700X Physician Assistant, Medical (Licence: GA 005529) | |
Enumeration Date | 2009-02-09 |
Last Update Date | 2025-08-13 |