| NPI | 1497173389 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CO DR.0058658) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA A155718) |
| 207P00000X Emergency Medicine (Licence: FL ME136621) | |
| Enumeration Date | 2014-03-28 |
| Last Update Date | 2018-08-23 |