| NPI | 1568099174 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CO 0069154) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: GA 92930) |
| Enumeration Date | 2020-03-24 |
| Last Update Date | 2023-06-23 |