| NPI | 1659671360 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CO DR.0058407) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 284626-1) |
| 207R00000X Internal Medicine (Licence: NY 284626-1) | |
| Enumeration Date | 2010-10-27 |
| Last Update Date | 2022-07-21 |