| NPI | 1700825015 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CO DR.0058622) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: GA 057432) |
| Enumeration Date | 2006-06-05 |
| Last Update Date | 2018-08-22 |