NPI | 1376590059 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: AL PA.189) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: AL PA-189) |
Enumeration Date | 2006-05-28 |
Last Update Date | 2024-05-23 |