NPI | 1699101063 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367H00000X Anesthesiologist Assistant (Licence: CO ANT.0000055) |
Additional Taxonomies | 367H00000X Anesthesiologist Assistant (Licence: MO 2013034524) |
Enumeration Date | 2013-09-17 |
Last Update Date | 2016-04-19 |