| NPI | 1942509708 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TN 64346) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NE 28695) |
| 207P00000X Emergency Medicine (Licence: NY 268160-1) | |
| 207P00000X Emergency Medicine (Licence: CO DR0053572) | |
| Enumeration Date | 2011-03-19 |
| Last Update Date | 2021-11-30 |