| NPI | 1710910146 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NM MD2008-0135) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CO 42552) |
| Enumeration Date | 2006-07-09 |
| Last Update Date | 2008-07-14 |