| NPI | 1437209996 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CO 32745) |
| Additional Taxonomies | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: CO 32745) |
| 207Q00000X Family Medicine (Licence: CO 32745) | |
| Enumeration Date | 2007-01-10 |
| Last Update Date | 2014-02-04 |