| NPI | 1033679238 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CO DR.0076251) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: UT 12722218-1204) |
| Enumeration Date | 2019-03-22 |
| Last Update Date | 2026-06-05 |