| NPI | 1003827049 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: CO 34894) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CO 34894) |
| 2083C0008X Preventive Medicine, Clinical Informatics Specialist (Licence: CO 34894) | |
| Enumeration Date | 2006-08-11 |
| Last Update Date | 2022-07-05 |