| NPI | 1902244734 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CO DR.0058359) |
| Additional Taxonomies | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: CO Dr.0058359) |
| Enumeration Date | 2013-06-14 |
| Last Update Date | 2023-04-26 |