| NPI | 1952994071 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367H00000X Anesthesiologist Assistant (Licence: IN 75000252A) |
| Additional Taxonomies | 367H00000X Anesthesiologist Assistant (Licence: DC AA2000013) |
| 367H00000X Anesthesiologist Assistant (Licence: FL AA942) | |
| Enumeration Date | 2021-02-19 |
| Last Update Date | 2026-06-24 |