| NPI | 1164955183 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME167209) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CO DR.0066498) |
| Enumeration Date | 2017-04-06 |
| Last Update Date | 2024-07-09 |