| 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 | 2024-12-03 |