| NPI | 1467562470 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: CO 44054) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: KS 04-39723) |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2021-12-14 |