NPI | 1225791007 |
---|---|
Other Name | JESSE SANTANA |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA.0007142) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2021-10-18 |
Last Update Date | 2022-01-10 |