| NPI | 1104138098 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CO DR0052131) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 4301097200) |
| Enumeration Date | 2010-07-08 |
| Last Update Date | 2013-06-17 |