NPI | 1851409213 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9103824) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL PA9103824) |
Enumeration Date | 2006-08-27 |
Last Update Date | 2008-01-28 |