| NPI | 1548522402 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CO 0055251) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CO TL-4357) |
| Enumeration Date | 2012-06-15 |
| Last Update Date | 2021-06-16 |