NPI | 1629526462 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367H00000X Anesthesiologist Assistant (Licence: GA 008105) |
Additional Taxonomies | 367H00000X Anesthesiologist Assistant (Licence: GA 8105) |
Enumeration Date | 2016-09-21 |
Last Update Date | 2021-08-18 |