| NPI | 1760868491 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CO DR.0062020) |
| Additional Taxonomies | 282N00000X General Acute Care Hospital |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-08-04 |
| Last Update Date | 2020-10-06 |