| NPI | 1417578923 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: GA 95335) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 4351046126) |
| 207PT0002X Emergency Medicine, Medical Toxicology (Licence: GA 95335) | |
| Enumeration Date | 2020-05-06 |
| Last Update Date | 2023-06-13 |