| NPI | 1255348173 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207PT0002X Emergency Medicine, Medical Toxicology (Licence: MI 4301072294) | 
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MI 4301072294) | 
| 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: MI 4301072294) | |
| 207PE0005X Emergency Medicine, Undersea and Hyperbaric Medicine (Licence: MI 4301072294) | |
| Enumeration Date | 2006-08-02 | 
| Last Update Date | 2025-02-21 |