| NPI | 1811164999 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CO DR49831) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: DE c7-0004027) |
| 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: CO 49831) | |
| Enumeration Date | 2008-05-08 |
| Last Update Date | 2025-02-18 |