| NPI | 1194868109 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CO DR.0036967) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX M2982) |
| Enumeration Date | 2007-02-15 |
| Last Update Date | 2025-09-09 |