| NPI | 1972041093 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CO CDR.0001413) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AZ 007800) |
| Enumeration Date | 2017-02-09 |
| Last Update Date | 2021-12-29 |