| NPI | 1194721621 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CO DR.0056278) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL ME42222) |
| Enumeration Date | 2005-06-21 |
| Last Update Date | 2016-09-27 |