NPI | 1942815063 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367H00000X Anesthesiologist Assistant (Licence: WI 170) |
Additional Taxonomies | 367H00000X Anesthesiologist Assistant (Licence: SC 117) |
Enumeration Date | 2020-09-15 |
Last Update Date | 2025-09-18 |