| NPI | 1083812366 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: AZ 35554) |
| Additional Taxonomies | 207PT0002X Emergency Medicine Medical Toxicology (Licence: AZ 77351) |
| Enumeration Date | 2007-07-06 |
| Last Update Date | 2007-07-08 |