| NPI | 1609040336 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 246832-1) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CO DR.0074468) |
| Enumeration Date | 2008-04-14 |
| Last Update Date | 2025-03-24 |