| NPI | 1700379229 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CO DR.0073456) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA OT018412) |
| Enumeration Date | 2018-06-09 |
| Last Update Date | 2024-08-14 |