| NPI | 1760456412 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CO CDRH.0031240) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CO 31240) |
| Enumeration Date | 2006-02-16 |
| Last Update Date | 2022-03-21 |