| NPI | 1093101909 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CO DR.0061954) | 
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 295319-1) | 
| Enumeration Date | 2015-04-08 | 
| Last Update Date | 2024-12-11 |