| NPI | 1003127192 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CO DR.0064663) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX P7768) |
| 207P00000X Emergency Medicine (Licence: NY 269569) | |
| Enumeration Date | 2010-06-23 |
| Last Update Date | 2026-04-06 |