| NPI | 1326010331 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PT0002X Emergency Medicine, Medical Toxicology (Licence: AZ 36261) |
| Additional Taxonomies | 174400000X Specialist (Licence: PA MD068432L) |
| Enumeration Date | 2006-02-03 |
| Last Update Date | 2008-03-13 |