| NPI | 1609046747 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CO DR.0060183) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: VA 0101243331) |
| Enumeration Date | 2008-03-05 |
| Last Update Date | 2021-07-27 |