NPI | 1942249511 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: TN 312) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: TN MW0564333) |
Enumeration Date | 2006-06-06 |
Last Update Date | 2024-06-11 |