| NPI | 1538167358 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CO DR.0050627) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: SC 27320) |
| Enumeration Date | 2005-07-14 |
| Last Update Date | 2013-06-19 |