| NPI | 1770740292 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CO 48984) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CO TL-2754) |
| Enumeration Date | 2008-05-21 |
| Last Update Date | 2011-10-24 |