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 |