| NPI | 1760413280 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CO 34626) |
| Additional Taxonomies | 174400000X Specialist (Licence: CO 34626) |
| Enumeration Date | 2006-07-05 |
| Last Update Date | 2011-02-24 |