Individual
MR. ROBERT LOUIS BODEN
Active
Individual
MR. ROBERT LOUIS BODEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CSA
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
SA044
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
755
NSAA
KY
01
—
SA044
KY BOARD OF MEDICAL LISCE
KY
Enumeration date
03/09/2007
Last updated
07/08/2007
Update your record
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