| NPI | 1568682722 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CO 50325) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: KS 0434371) |
| Enumeration Date | 2007-04-27 |
| Last Update Date | 2013-08-14 |