| NPI | 1730313560 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CO 50967) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CO 3232) |
| Enumeration Date | 2009-05-07 |
| Last Update Date | 2021-06-21 |