| NPI | 1962842708 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CO DR.0056586) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WI 72575-20) |
| Enumeration Date | 2013-06-25 |
| Last Update Date | 2024-09-17 |