| NPI | 1497289516 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CO DR.0066616) |
| Additional Taxonomies | 208600000X Surgery (Licence: AZ R76067) |
| Enumeration Date | 2017-04-14 |
| Last Update Date | 2021-11-24 |