NPI | 1255053278 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 367H00000X Anesthesiologist Assistant (Licence: IN 75000140A) |
Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL 761) |
367H00000X Anesthesiologist Assistant (Licence: TX 32698309) | |
Enumeration Date | 2022-09-15 |
Last Update Date | 2023-08-16 |