| NPI | 1487102356 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: IN 75000005A) | 
| Additional Taxonomies | 367H00000X Anesthesiologist Assistant (Licence: IN 75000005A) | 
| Enumeration Date | 2016-09-20 | 
| Last Update Date | 2025-02-17 |