| NPI | 1639631880 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CO DR.0068344) |
| Additional Taxonomies | 207QA0401X Family Medicine, Addiction Medicine (Licence: CO 0068344) |
| Enumeration Date | 2019-04-04 |
| Last Update Date | 2022-08-25 |