NPI | 1467150979 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: TN 5368) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: TN 5368) |
Enumeration Date | 2023-02-23 |
Last Update Date | 2025-06-16 |