NPI | 1225446537 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367H00000X Anesthesiologist Assistant (Licence: CO ANT.0000138) |
Additional Taxonomies | 367H00000X Anesthesiologist Assistant (Licence: MO 2014026440) |
Enumeration Date | 2014-07-30 |
Last Update Date | 2020-11-17 |