| NPI | 1659692614 |
|---|---|
| Former Name | JASON ERIC JAETAO |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NM MD2014-0752) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2010-06-14 |
| Last Update Date | 2014-10-24 |