NPI | 1568299253 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: IN 01082531A) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2024-09-17 |
Last Update Date | 2024-10-28 |