| NPI | 1346776242 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CO DR.0070949) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MO 2020020741) |
| Enumeration Date | 2017-05-11 |
| Last Update Date | 2025-08-04 |