| NPI | 1396783726 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CO DR0061273) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IA 27694) |
| Enumeration Date | 2006-06-04 |
| Last Update Date | 2018-09-27 |