| NPI | 1871904599 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CO DR.0058884) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NC 201708) |
| Enumeration Date | 2014-05-15 |
| Last Update Date | 2017-08-08 |