NPI | 1922070101 |
---|---|
Other Name | TROY STUCKER |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant Surgical (Licence: KS 1501122) |
Additional Taxonomies | 363AS0400X Physician Assistant Surgical (Licence: MO 2006001741) |
Enumeration Date | 2006-02-02 |
Last Update Date | 2007-12-20 |