| NPI | 1497027932 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367H00000X Anesthesiologist Assistant (Licence: IN 75000103A) |
| Additional Taxonomies | 367H00000X Anesthesiologist Assistant |
| 367H00000X Anesthesiologist Assistant (Licence: GA 006371) | |
| 367H00000X Anesthesiologist Assistant (Licence: FL AA325) | |
| Enumeration Date | 2012-01-30 |
| Last Update Date | 2022-06-09 |