NPI | 1447726260 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA12411) |
Enumeration Date | 2018-10-18 |
Last Update Date | 2023-08-17 |