| NPI | 1619357472 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CO DR.0061961) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 5101021935) |
| Enumeration Date | 2015-06-05 |
| Last Update Date | 2020-07-27 |