| NPI | 1265174890 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CO DR.0074837) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX V1846) |
| Enumeration Date | 2022-04-13 |
| Last Update Date | 2025-06-27 |