| NPI | 1891181764 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CO DR.0061570) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207L00000X Anesthesiology (Licence: UT 10104221-1205) | |
| Enumeration Date | 2015-04-07 |
| Last Update Date | 2021-11-11 |