| NPI | 1194278580 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OK 33492) | 
| Additional Taxonomies | 207PT0002X Emergency Medicine, Medical Toxicology (Licence: PA MT212268) | 
| Enumeration Date | 2016-08-02 | 
| Last Update Date | 2021-08-06 |