| NPI | 1316238421 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CO DR.0058964) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MN 56853) |
| 207R00000X Internal Medicine (Licence: MN 56853) | |
| Enumeration Date | 2011-04-23 |
| Last Update Date | 2020-06-01 |