| NPI | 1326248915 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CO 46707) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AZ 37241) |
| Enumeration Date | 2007-07-20 |
| Last Update Date | 2008-07-29 |