| NPI | 1689931131 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CO DR.0058463) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MA 261853) |
| Enumeration Date | 2012-04-20 |
| Last Update Date | 2022-07-21 |