NPI | 1154415404 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367H00000X Anesthesiologist Assistant (Licence: FL AA85) |
Additional Taxonomies | 367H00000X Anesthesiologist Assistant (Licence: GA 001965) |
Enumeration Date | 2006-10-03 |
Last Update Date | 2011-11-04 |