| NPI | 1487049730 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 287673) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CO DR.0072019) |
| 207P00000X Emergency Medicine (Licence: NM MD2023-1550) | |
| Enumeration Date | 2015-04-03 |
| Last Update Date | 2024-06-21 |