| NPI | 1548558661 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367H00000X Anesthesiologist Assistant (Licence: GA 6226) |
| Additional Taxonomies | 367H00000X Anesthesiologist Assistant |
| Enumeration Date | 2011-07-11 |
| Last Update Date | 2023-11-29 |