| NPI | 1649334517 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QG0300X Family Medicine Geriatric Medicine (Licence: CO 26062) |
| Additional Taxonomies | 207PE0004X Emergency Medicine Emergency Medical Services (Licence: CO 26062) |
| Enumeration Date | 2006-12-21 |
| Last Update Date | 2016-05-20 |