| NPI | 1871056267 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 367H00000X Anesthesiologist Assistant (Licence: IN 75000136A) | 
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: IN 75000136A) | 
| 367H00000X Anesthesiologist Assistant (Licence: WI 136) | |
| Enumeration Date | 2019-04-11 | 
| Last Update Date | 2024-03-13 |