Individual
DANIEL STEPHEN BLAKE
Active
Individual
DANIEL STEPHEN BLAKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
SURGICAL FIRST ASST
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
F01309
AZ
Other
Enumeration date
08/07/2006
Last updated
09/16/2019
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