| NPI | 1326381252 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CO DR.0066340) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: GU MTL-2019-018) |
| 207P00000X Emergency Medicine (Licence: NE 28243) | |
| 207P00000X Emergency Medicine (Licence: GU M-2175) | |
| Enumeration Date | 2013-03-28 |
| Last Update Date | 2021-09-30 |