| NPI | 1841624293 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 367H00000X Anesthesiologist Assistant (Licence: GA 7936) |
| Additional Taxonomies | 367H00000X Anesthesiologist Assistant |
| Enumeration Date | 2013-08-21 |
| Last Update Date | 2024-08-20 |