| NPI | 1346690823 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CO DR.0066765) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: CO TL 0006311) |
| Enumeration Date | 2016-06-15 |
| Last Update Date | 2022-01-31 |