| NPI | 1134547557 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CO DR.0058185) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NM 'RS2014-0418) |
| Enumeration Date | 2014-04-02 |
| Last Update Date | 2017-06-30 |