NPI | 1336827435 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA OA006519) |
Additional Taxonomies | 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: PA OA006519) |
363AS0400X Physician Assistant, Surgical (Licence: PA OA006519) | |
Enumeration Date | 2023-07-10 |
Last Update Date | 2023-07-11 |