NPI | 1710711767 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NH 2856) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NH 2856) |
Enumeration Date | 2024-08-30 |
Last Update Date | 2024-09-04 |