NPI | 1851081608 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: IL 085009965) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2023-05-15 |
Last Update Date | 2023-09-07 |