| NPI | 1700220357 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: ID MC-0758) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CO DR0057190) |
| Enumeration Date | 2013-04-25 |
| Last Update Date | 2022-05-06 |