| NPI | 1346635299 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CO DR.0070361) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NV DO2381) |
| Enumeration Date | 2015-03-30 |
| Last Update Date | 2024-01-23 |