| NPI | 1396978540 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 367H00000X Anesthesiologist Assistant (Licence: IN 75000147A) |
| Additional Taxonomies | 367H00000X Anesthesiologist Assistant (Licence: GA 1911) |
| Enumeration Date | 2009-09-03 |
| Last Update Date | 2025-05-14 |