| NPI | 1780851113 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: CO TL-2607) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CO 49520) |
| Enumeration Date | 2008-05-14 |
| Last Update Date | 2010-12-20 |