NPI | 1588403802 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 367H00000X Anesthesiologist Assistant |
Additional Taxonomies | 367H00000X Anesthesiologist Assistant (Licence: DC 789790159) |
Enumeration Date | 2024-05-24 |
Last Update Date | 2024-10-14 |