| NPI | 1477523652 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367H00000X Anesthesiologist Assistant |
| Additional Taxonomies | 367H00000X Anesthesiologist Assistant (Licence: AL AA.840) |
| Enumeration Date | 2006-01-23 |
| Last Update Date | 2018-11-27 |