| NPI | 1699957308 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: KY 56216) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CO CDRH.0067468) |
| Enumeration Date | 2007-12-04 |
| Last Update Date | 2024-02-26 |