| NPI | 1619110715 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CO CDRH.0054057) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA A114082) |
| 207L00000X Anesthesiology (Licence: CO DR.0054057) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2009-04-20 |
| Last Update Date | 2023-03-04 |