| NPI | 1730499336 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA 20A11105) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CO DR.0074463) |
| Enumeration Date | 2010-10-15 |
| Last Update Date | 2025-03-24 |