| NPI | 1750525994 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CO DR.0059079) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: VA 0101253791) |
| 207L00000X Anesthesiology (Licence: MA 257764) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2009-04-30 |
| Last Update Date | 2019-11-19 |