| NPI | 1902293376 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CO DR.0067052) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NH 18856) |
| Enumeration Date | 2015-04-23 |
| Last Update Date | 2021-09-01 |