NPI | 1194837724 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367H00000X Anesthesiologist Assistant (Licence: FL AA260) |
Additional Taxonomies | 367H00000X Anesthesiologist Assistant (Licence: GA 4631) |
Enumeration Date | 2006-08-31 |
Last Update Date | 2021-04-26 |