| NPI | 1821594458 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CO DR.0074433) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CT 67536) |
| Enumeration Date | 2018-04-03 |
| Last Update Date | 2025-04-01 |