| NPI | 1568437911 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CO 0063555) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MD422749) |
| Enumeration Date | 2006-02-21 |
| Last Update Date | 2020-08-26 |