| NPI | 1083976864 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CO DR.0060908) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 4301101188) |
| Enumeration Date | 2012-06-08 |
| Last Update Date | 2019-01-24 |