| NPI | 1538485297 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CO DR.0053567) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NC 2012-00828) |
| Enumeration Date | 2010-04-20 |
| Last Update Date | 2021-11-03 |