| NPI | 1750474177 |
|---|---|
| Former Name | JEREMY DANIEL SPEARMAN |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA 19825) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: UT 51942131206) |
| 363AM0700X Physician Assistant, Medical (Licence: UT 51942131206) | |
| Enumeration Date | 2006-09-30 |
| Last Update Date | 2015-02-05 |