| NPI | 1902289101 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: IN 75000029A) |
| Additional Taxonomies | 367H00000X Anesthesiologist Assistant |
| 367H00000X Anesthesiologist Assistant (Licence: IN 75000029A) | |
| Enumeration Date | 2015-07-07 |
| Last Update Date | 2024-12-02 |