| NPI | 1801206248 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CO DR.0066697) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WI 73770) |
| Enumeration Date | 2014-05-07 |
| Last Update Date | 2021-08-24 |