| NPI | 1063953909 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PT0002X Emergency Medicine, Medical Toxicology (Licence: VA 0102206595) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OK 6409) |
| Enumeration Date | 2017-03-11 |
| Last Update Date | 2026-02-05 |