| NPI | 1376992420 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: CO DR.0066699) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL UO5342) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: WI 72454-21) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: CO TL0006255) | |
| Enumeration Date | 2016-06-09 |
| Last Update Date | 2021-06-29 |