| NPI | 1770541336 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CO DR.0039236) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CO 39236) |
| Enumeration Date | 2006-05-03 |
| Last Update Date | 2021-10-22 |