| NPI | 1548496052 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: GA 96713) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CO MD62736) |
| 207P00000X Emergency Medicine (Licence: CO DR.0062736) | |
| 207P00000X Emergency Medicine (Licence: OR 170273) | |
| Enumeration Date | 2009-06-10 |
| Last Update Date | 2025-04-28 |