| NPI | 1538798376 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: AZ 75854) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CO DR.0072934) |
| Enumeration Date | 2020-04-03 |
| Last Update Date | 2026-02-23 |