| NPI | 1518916774 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CO 41372) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MA 239652) |
| Enumeration Date | 2006-05-08 |
| Last Update Date | 2026-02-04 |