| NPI | 1821018318 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: CO DR.0042353) |
| Additional Taxonomies | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: UT 6176544-1205) |
| Enumeration Date | 2006-07-20 |
| Last Update Date | 2024-03-29 |