| NPI | 1376040428 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: VA 0102206519) | 
| Additional Taxonomies | 207PT0002X Emergency Medicine, Medical Toxicology (Licence: VA 0102206519) | 
| Enumeration Date | 2018-04-06 | 
| Last Update Date | 2024-11-22 |