| NPI | 1518372457 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CO DR.0062425) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA A142325) |
| Enumeration Date | 2014-06-30 |
| Last Update Date | 2023-07-14 |