NPI | 1720154594 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: GA 004894) |
Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: GA 004894) |
Enumeration Date | 2006-11-25 |
Last Update Date | 2011-03-25 |