| NPI | 1952461634 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CO 20312) |
| Additional Taxonomies | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: CO 20312) |
| Enumeration Date | 2006-12-11 |
| Last Update Date | 2012-06-18 |