| NPI | 1699093575 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MI 43011046189) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CO TL-3621) |
| Enumeration Date | 2010-05-17 |
| Last Update Date | 2021-12-19 |