| NPI | 1679233118 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367H00000X Anesthesiologist Assistant (Licence: IN 75000098A) |
| Additional Taxonomies | 367H00000X Anesthesiologist Assistant (Licence: SC TL95) |
| 367H00000X Anesthesiologist Assistant | |
| Enumeration Date | 2021-12-25 |
| Last Update Date | 2023-08-29 |