| NPI | 1316478274 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CO DR.0063780) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NM MD2019-754) |
| Enumeration Date | 2017-03-22 |
| Last Update Date | 2022-11-01 |