NPI | 1407942717 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: IN 10000403A) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: IN 10000403) |
Enumeration Date | 2006-10-05 |
Last Update Date | 2023-10-04 |