NPI | 1538146766 |
---|---|
Other Name | JOEL DANTES DIZON |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NH 0903) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: WA PA10004702) |
363AM0700X Physician Assistant, Medical (Licence: WI 2551-023) | |
Enumeration Date | 2005-12-29 |
Last Update Date | 2017-05-05 |