| NPI | 1487628434 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CO 42492) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NM 2002-0063) |
| Enumeration Date | 2006-02-15 |
| Last Update Date | 2011-03-08 |