| NPI | 1538374160 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CO DR.0047831) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MN 52770) |
| Enumeration Date | 2007-05-14 |
| Last Update Date | 2021-06-15 |