| NPI | 1992729974 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MO 2012003313) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NM MD2007-0452) |
| 207P00000X Emergency Medicine (Licence: CO CO43263) | |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2018-12-27 |