| NPI | 1265876916 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CO DR.00057926) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 5101020266) |
| Enumeration Date | 2013-04-24 |
| Last Update Date | 2018-03-17 |