| NPI | 1447220041 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QS0010X Family Medicine, Sports Medicine (Licence: CO DR.0062333) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: GA 050407) |
| 207Q00000X Family Medicine (Licence: VA 0101102492) | |
| 2083A0100X Preventive Medicine, Aerospace Medicine (Licence: CO DR.0062333) | |
| Enumeration Date | 2006-01-25 |
| Last Update Date | 2019-08-03 |