| NPI | 1154859577 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CO DR.0065692) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: UT 10959136-1205) |
| Enumeration Date | 2017-05-30 |
| Last Update Date | 2024-01-19 |