| NPI | 1598463887 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: IN 75000256A) |
| Additional Taxonomies | 367H00000X Anesthesiologist Assistant (Licence: FL AA807) |
| Enumeration Date | 2023-02-16 |
| Last Update Date | 2026-08-18 |