NPI | 1558494294 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: OR PA00323) |
Additional Taxonomies | 207RE0101X Internal Medicine Endocrinology, Diabetes & Metabolism (Licence: OR PA00323) |
Enumeration Date | 2007-03-13 |
Last Update Date | 2015-09-02 |