| NPI | 1548373632 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OR OR MD25599) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CO DR.0067280) |
| Enumeration Date | 2006-08-16 |
| Last Update Date | 2022-03-31 |