| NPI | 1114545217 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: SC 96769) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MO 2023004726) |
| 207PT0002X Emergency Medicine, Medical Toxicology (Licence: SC 96769) | |
| Enumeration Date | 2020-07-06 |
| Last Update Date | 2026-08-24 |