| NPI | 1205253127 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NC 2019-01016) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CO DR.0058595) |
| Enumeration Date | 2014-03-28 |
| Last Update Date | 2019-09-05 |