| NPI | 1215187919 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CO 47679) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CT 046518) |
| 207P00000X Emergency Medicine (Licence: NY 247229) | |
| Enumeration Date | 2008-09-30 |
| Last Update Date | 2022-07-21 |