| NPI | 1184924037 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367H00000X Anesthesiologist Assistant (Licence: IN 75000035A) |
| Additional Taxonomies | 367H00000X Anesthesiologist Assistant (Licence: OH 67.000177) |
| 367H00000X Anesthesiologist Assistant (Licence: GA 006341) | |
| 367H00000X Anesthesiologist Assistant (Licence: WI 7517) | |
| Enumeration Date | 2010-10-26 |
| Last Update Date | 2018-12-06 |