| NPI | 1598790198 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CO DR.0034745) |
| Additional Taxonomies | 204D00000X Neuromusculoskeletal Medicine & OMM (Licence: CO 34745) |
| 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: CO 0320000502) | |
| 207Q00000X Family Medicine (Licence: CO 34745) | |
| Enumeration Date | 2006-07-11 |
| Last Update Date | 2022-08-23 |