| NPI | 1184699803 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CO 42440) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NM MD2003-0723) |
| Enumeration Date | 2006-02-17 |
| Last Update Date | 2018-10-22 |