| NPI | 1881980068 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CO DR.0053983) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 4301099206) |
| Enumeration Date | 2011-06-25 |
| Last Update Date | 2014-09-25 |