| 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 | 2019-05-23 |