| 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: OR MD228106) |
| 207P00000X Emergency Medicine (Licence: DE C10007162) | |
| Enumeration Date | 2006-01-03 |
| Last Update Date | 2025-11-19 |