| NPI | 1366604944 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PT0002X Emergency Medicine, Medical Toxicology (Licence: SC 37063) |
| Additional Taxonomies | 207PT0002X Emergency Medicine, Medical Toxicology (Licence: NY 259804) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2008-06-25 |
| Last Update Date | 2020-10-08 |