| NPI | 1467405548 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CO DR.0055216) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: VA 0101046664) |
| 207P00000X Emergency Medicine (Licence: MD D0041624) | |
| Enumeration Date | 2006-05-18 |
| Last Update Date | 2018-05-10 |