| NPI | 1164400487 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MD D0056446) |
| Additional Taxonomies | 207PT0002X Emergency Medicine, Medical Toxicology (Licence: TX P3678) |
| Enumeration Date | 2006-01-06 |
| Last Update Date | 2012-07-24 |