| NPI | 1700271921 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CO DR.0060138) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: GA 82654) |
| Enumeration Date | 2015-04-03 |
| Last Update Date | 2019-05-15 |