| NPI | 1417336595 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CO Dr0062698) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 5101021765) |
| Enumeration Date | 2015-05-22 |
| Last Update Date | 2019-08-14 |