| NPI | 1396759064 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: GA 41903) |
| Additional Taxonomies | 207PT0002X Emergency Medicine, Medical Toxicology (Licence: GA 041903) |
| Enumeration Date | 2006-07-28 |
| Last Update Date | 2018-01-12 |