NPI | 1427641638 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL 9117095) |
Additional Taxonomies | 208M00000X Hospitalist (Licence: NC 0010-10993) |
Enumeration Date | 2021-02-18 |
Last Update Date | 2023-03-27 |