| NPI | 1154688505 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CO DR.0055298) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WI 73384) |
| Enumeration Date | 2012-04-23 |
| Last Update Date | 2024-02-13 |