| NPI | 1992896922 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CO DR.0032169) | 
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NE 23067) | 
| Enumeration Date | 2006-09-27 | 
| Last Update Date | 2022-02-22 |