| NPI | 1649260613 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CO DR 0020914) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA G41348) |
| Enumeration Date | 2005-10-21 |
| Last Update Date | 2013-10-29 |