NPI | 1427422013 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO 4478) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical |
Enumeration Date | 2015-11-19 |
Last Update Date | 2016-02-16 |