| NPI | 1568954196 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CO DR.0071086) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MD H93967) |
| 207P00000X Emergency Medicine (Licence: PA OT018404) | |
| Enumeration Date | 2018-05-30 |
| Last Update Date | 2023-07-20 |