| NPI | 1700315934 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CO DR.0065561) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MT214066) |
| 207P00000X Emergency Medicine (Licence: PA MD468700) | |
| Enumeration Date | 2017-06-10 |
| Last Update Date | 2022-04-06 |