NPI | 1922042522 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367H00000X Anesthesiologist Assistant |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: MD C0000466) |
Enumeration Date | 2006-06-15 |
Last Update Date | 2010-08-19 |