| NPI | 1710312301 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367H00000X Anesthesiologist Assistant (Licence: 1510) |
| Additional Taxonomies | 367H00000X Anesthesiologist Assistant (Licence: IN 75000024A) |
| Enumeration Date | 2013-09-13 |
| Last Update Date | 2024-12-03 |