NPI | 1164289120 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 12422) |
Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: GA 12422) |
Enumeration Date | 2024-03-05 |
Last Update Date | 2024-08-15 |