| NPI | 1396255378 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367H00000X Anesthesiologist Assistant (Licence: IN 75000174A) |
| Additional Taxonomies | 367H00000X Anesthesiologist Assistant (Licence: FL AA410) |
| Enumeration Date | 2017-10-04 |
| Last Update Date | 2024-10-18 |