| NPI | 1770825184 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: CO 0056666) |
| Additional Taxonomies | 207PS0010X Emergency Medicine, Sports Medicine (Licence: UT 10288825-1205) |
| 207P00000X Emergency Medicine (Licence: UT 10288825-1205) | |
| Enumeration Date | 2013-03-24 |
| Last Update Date | 2024-05-13 |