| NPI | 1184201428 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CO DR.0072932) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: GA 103176) |
| Enumeration Date | 2021-03-24 |
| Last Update Date | 2025-03-05 |