| NPI | 1548575855 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CO DR.0065588) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WI 64955) |
| 207P00000X Emergency Medicine (Licence: IL 036-128473) | |
| Enumeration Date | 2010-08-11 |
| Last Update Date | 2021-09-03 |