| NPI | 1629168687 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CO DR.0037722) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 5101012698) |
| 207P00000X Emergency Medicine (Licence: WI 2920) | |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2024-03-25 |