| NPI | 1528014461 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CO DR.0063534) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CO 0063534) |
| Enumeration Date | 2006-05-25 |
| Last Update Date | 2023-12-05 |