| NPI | 1205275534 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PT0002X Emergency Medicine, Medical Toxicology (Licence: TX U5387) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MO 2019015598) |
| 207PT0002X Emergency Medicine, Medical Toxicology (Licence: MO 2019015598) | |
| 208D00000X General Practice (Licence: MO 2019015598) | |
| Enumeration Date | 2013-06-20 |
| Last Update Date | 2023-09-22 |