| NPI | 1306893896 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PT0002X Emergency Medicine, Medical Toxicology (Licence: WI 37218) |
| Additional Taxonomies | 207PT0002X Emergency Medicine, Medical Toxicology (Licence: VA 0101234771) |
| Enumeration Date | 2006-05-28 |
| Last Update Date | 2007-10-10 |