| NPI | 1649507336 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CO 16244) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NH 4439) |
| Enumeration Date | 2009-11-17 |
| Last Update Date | 2009-11-17 |