| NPI | 1285096222 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: CO DR.0068903) |
| Additional Taxonomies | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: NM MD2019-0980) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-03-28 |
| Last Update Date | 2024-02-02 |