| NPI | 1932569266 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CO 65861) |
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: CO 65861) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-02-29 |
| Last Update Date | 2025-10-15 |