| NPI | 1215956768 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CO CDRH.0001899) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: UT 6890717-1205) |
| 207P00000X Emergency Medicine (Licence: IN 01055853A) | |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2024-07-09 |