| NPI | 1457095036 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CO DR.0077379) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MO 2023035253) |
| Enumeration Date | 2022-04-21 |
| Last Update Date | 2026-08-11 |