NPI | 1598913022 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: TN 1881) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: TN 1881) |
363A00000X Physician Assistant (Licence: UT 7098483-1206) | |
Enumeration Date | 2008-09-09 |
Last Update Date | 2011-03-21 |