| NPI | 1487187787 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CO DR.0066094) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: CO TL.0006429) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: CO TL.00007434) | |
| Enumeration Date | 2017-04-04 |
| Last Update Date | 2021-04-30 |