| NPI | 1154735470 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PT0002X Emergency Medicine, Medical Toxicology (Licence: NY 291069) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 291069) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-06-14 |
| Last Update Date | 2021-11-02 |