NPI | 1942762000 |
---|---|
Other Name | BRYAN CHAVEZ |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 7625) |
Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: AZ 7625) |
Enumeration Date | 2019-04-05 |
Last Update Date | 2024-07-16 |