NPI | 1669252763 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367H00000X Anesthesiologist Assistant (Licence: CO ANT.0000248) |
Additional Taxonomies | 367H00000X Anesthesiologist Assistant (Licence: MO pending) |
Enumeration Date | 2023-10-05 |
Last Update Date | 2024-06-05 |