| NPI | 1912955329 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CO DR.0052063) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX L7049) |
| 207P00000X Emergency Medicine (Licence: NM MD2012-0876) | |
| Enumeration Date | 2006-05-05 |
| Last Update Date | 2023-11-09 |