| NPI | 1891149084 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: GA 84977) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CO DR.0061629) |
| Enumeration Date | 2016-04-14 |
| Last Update Date | 2020-07-06 |