NPI | 1124556261 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 367H00000X Anesthesiologist Assistant (Licence: IN 75000146A) |
Additional Taxonomies | 367H00000X Anesthesiologist Assistant (Licence: 23865827) |
Enumeration Date | 2017-06-02 |
Last Update Date | 2024-08-08 |