| NPI | 1336126408 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CO 39044) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: KY 36395) |
| Enumeration Date | 2005-12-29 |
| Last Update Date | 2022-02-07 |