| NPI | 1962997601 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CO DR.0072296) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AZ 008986) |
| 207P00000X Emergency Medicine (Licence: MI 5101023954) | |
| Enumeration Date | 2018-06-26 |
| Last Update Date | 2024-03-15 |