| NPI | 1063490878 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CO DR.0049474) | 
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: DE C10007162) | 
| Enumeration Date | 2006-01-03 | 
| Last Update Date | 2024-12-12 |