| NPI | 1205323771 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CO DR.0067238) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: TL.0007364) |
| Enumeration Date | 2018-04-19 |
| Last Update Date | 2022-04-23 |