| NPI | 1457613184 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CO DR.0055339) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CO TL-4358) |
| Enumeration Date | 2012-06-08 |
| Last Update Date | 2021-06-04 |