| NPI | 1912325226 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CO DR.0057875) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NM 'RS2014-0398) |
| Enumeration Date | 2014-04-03 |
| Last Update Date | 2022-07-21 |