| NPI | 1225399579 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CO DR.0054585) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 4301100735) |
| Enumeration Date | 2012-06-04 |
| Last Update Date | 2016-01-04 |