| NPI | 1205949385 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CO 29192) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CO 29192) |
| Enumeration Date | 2006-08-16 |
| Last Update Date | 2021-05-06 |