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 |