| NPI | 1902068364 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CO DR.0059000) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL OS10749) |
| Enumeration Date | 2008-06-27 |
| Last Update Date | 2018-03-17 |