| NPI | 1265055388 |
|---|---|
| Other Name | TY KEITH YOCUM |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 9410) |
| Additional Taxonomies | 2086S0127X Surgery Trauma Surgery (Licence: AZ 9410) |
| 363AS0400X Physician Assistant Surgical (Licence: AZ 9410) | |
| Enumeration Date | 2020-05-22 |
| Last Update Date | 2024-07-22 |