| NPI | 1679695548 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CO DR.0057553) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OK 4492) |
| 207Q00000X Family Medicine (Licence: CO DR.0057553) | |
| Enumeration Date | 2007-04-04 |
| Last Update Date | 2017-02-16 |