| NPI | 1902301047 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CO DR.0072671) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA 165858) |
| Enumeration Date | 2018-03-29 |
| Last Update Date | 2024-05-23 |