| NPI | 1366730376 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CO DR.0056712) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AZ R72598) |
| 207P00000X Emergency Medicine (Licence: AZ 46722) | |
| Enumeration Date | 2011-07-12 |
| Last Update Date | 2022-07-21 |