| NPI | 1447889548 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: IN 28211638A) | 
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: IN 28211638A) | 
| 367500000X Nurse Anesthetist, Certified Registered (Licence: OR 202206135CRNA) | |
| Enumeration Date | 2020-04-02 | 
| Last Update Date | 2022-10-19 |