| NPI | 1548779887 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IN 10002320A) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IN 10002320A) |
| 363A00000X Physician Assistant (Licence: IL 085006703) | |
| Enumeration Date | 2017-09-28 |
| Last Update Date | 2020-10-12 |