NPI | 1386314375 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 11675) |
Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: GA 11675) |
Enumeration Date | 2021-09-20 |
Last Update Date | 2023-09-25 |