| NPI | 1033108915 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CO 45777) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NE 285) |
| Enumeration Date | 2005-10-13 |
| Last Update Date | 2010-11-02 |