| NPI | 1306475348 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367H00000X Anesthesiologist Assistant (Licence: DC AA000132) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: IN 75000225A) |
| 367H00000X Anesthesiologist Assistant (Licence: IN 75000225A) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2020-04-02 |
| Last Update Date | 2026-01-14 |