| NPI | 1649486721 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CO 49836) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CO 049836) |
| 207P00000X Emergency Medicine (Licence: MI 4301084481) | |
| Enumeration Date | 2007-05-15 |
| Last Update Date | 2018-03-14 |