| NPI | 1699232736 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367H00000X Anesthesiologist Assistant (Licence: IN 75000113A) |
| Additional Taxonomies | 367H00000X Anesthesiologist Assistant (Licence: TX 32375752) |
| 367H00000X Anesthesiologist Assistant (Licence: OK 26) | |
| Enumeration Date | 2019-02-25 |
| Last Update Date | 2025-12-09 |