| NPI | 1205239332 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX R7754) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 286783-1) |
| 207PT0002X Emergency Medicine, Medical Toxicology (Licence: NY 286783-1) | |
| 2080T0002X Pediatrics, Medical Toxicology (Licence: NY 286783-1) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-10-03 |
| Last Update Date | 2023-02-14 |