| NPI | 1639228059 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CO DR.0052668) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MS 18713) |
| Enumeration Date | 2007-01-09 |
| Last Update Date | 2013-06-19 |