NPI | 1639653132 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367H00000X Anesthesiologist Assistant (Licence: FL AA724) |
Additional Taxonomies | 367H00000X Anesthesiologist Assistant |
Enumeration Date | 2018-09-20 |
Last Update Date | 2023-03-16 |