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 |