| NPI | 1255642245 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CO DR.0054047) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: CO TL-3699) |
| Enumeration Date | 2010-06-24 |
| Last Update Date | 2018-05-15 |