| NPI | 1245403823 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CO 47757) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AZ 80912) |
| Enumeration Date | 2008-04-03 |
| Last Update Date | 2013-08-14 |