| NPI | 1699885277 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CO 39606) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: VA 0101256119) |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2024-05-10 |