| NPI | 1700981628 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CO DR.0077237) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CT 73124) |
| Enumeration Date | 2006-09-14 |
| Last Update Date | 2026-07-17 |