NPI | 1477928208 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: TN 4966) |
Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TN 4966) |
207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: TN 4966) | |
363AS0400X Physician Assistant, Surgical (Licence: IL 085.005742) | |
363AS0400X Physician Assistant, Surgical (Licence: TN 4966) | |
Enumeration Date | 2015-12-04 |
Last Update Date | 2022-06-16 |