| NPI | 1326121237 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CO 32862) |
| Additional Taxonomies | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: CO 32862) |
| Enumeration Date | 2006-10-23 |
| Last Update Date | 2026-09-24 |