NPI | 1811922834 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA052411) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MA052411) |
Enumeration Date | 2006-07-11 |
Last Update Date | 2014-10-31 |