| NPI | 1578436580 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367H00000X Anesthesiologist Assistant (Licence: IN 75000260A) |
| Additional Taxonomies | 367H00000X Anesthesiologist Assistant (Licence: MO pending) |
| Enumeration Date | 2025-09-25 |
| Last Update Date | 2026-09-02 |