| NPI | 1114364429 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CO CDRH.0067064) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IA MD-42661) |
| Enumeration Date | 2013-05-28 |
| Last Update Date | 2025-03-06 |