NPI | 1295424323 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: SC 4838) |
Additional Taxonomies | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: SC 4838) |
Enumeration Date | 2023-05-04 |
Last Update Date | 2023-12-08 |