| NPI | 1578539052 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CO 46155) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MN 39142) |
| Enumeration Date | 2006-02-24 |
| Last Update Date | 2009-01-29 |