| NPI | 1407099476 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CO CDR.0000456) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WI 55696-20) |
| Enumeration Date | 2009-04-07 |
| Last Update Date | 2020-03-10 |