NPI | 1245276278 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367H00000X Anesthesiologist Assistant (Licence: MD c02961) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2006-06-20 |
Last Update Date | 2011-06-01 |