| NPI | 1982135745 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CO DR.0071645) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MD473936) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: CO TL.0009803) | |
| Enumeration Date | 2017-03-23 |
| Last Update Date | 2023-11-09 |