| NPI | 1932602737 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WA MD61274239) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CO DR.0063292) |
| Enumeration Date | 2018-03-18 |
| Last Update Date | 2023-03-08 |