| NPI | 1932581451 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CO DR.0061500) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 5101021807) |
| Enumeration Date | 2015-06-20 |
| Last Update Date | 2024-05-15 |