NPI | 1518261825 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367H00000X Anesthesiologist Assistant (Licence: GA 6032) |
Additional Taxonomies | 367H00000X Anesthesiologist Assistant (Licence: GA 1151) |
Enumeration Date | 2010-12-29 |
Last Update Date | 2022-10-24 |