NPI | 1659840643 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: OK 3011) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: OK 3011) |
Enumeration Date | 2018-11-19 |
Last Update Date | 2021-02-07 |