| NPI | 1972923183 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: UT 9538403-1205) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CO DR.0060573) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-04-27 |
| Last Update Date | 2018-06-12 |