| NPI | 1982099925 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CO DR.0066745) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA A161694) |
| 207P00000X Emergency Medicine (Licence: WA MD60760155) | |
| Enumeration Date | 2015-04-06 |
| Last Update Date | 2021-10-04 |