| NPI | 1629397153 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA 130811) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CO TL-3588) |
| 207P00000X Emergency Medicine (Licence: CO 52351) | |
| Enumeration Date | 2010-05-24 |
| Last Update Date | 2021-10-21 |