| NPI | 1073562955 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CO DR.0037494) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MD D58128) |
| Enumeration Date | 2006-05-09 |
| Last Update Date | 2018-08-27 |