NPI | 1992154934 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 53913) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA PA53913) |
Enumeration Date | 2016-06-09 |
Last Update Date | 2025-08-12 |