| NPI | 1942269287 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IN 10000787A) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IN 99017012A) |
| Enumeration Date | 2006-03-23 |
| Last Update Date | 2022-02-15 |