| NPI | 1578141529 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CO DR.0075254) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NM MD2024-0471) |
| Enumeration Date | 2021-03-31 |
| Last Update Date | 2025-07-08 |