| NPI | 1598401044 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CO DR.0075373) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX V0885) |
| Enumeration Date | 2022-05-09 |
| Last Update Date | 2025-07-01 |