| NPI | 1447204466 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WI 31080) |
| Additional Taxonomies | 207PE0004X Emergency Medicine Emergency Medical Services (Licence: WI 31080) |
| 207PP0204X Emergency Medicine Pediatric Emergency Medicine (Licence: WI 31080) | |
| 207PT0002X Emergency Medicine Medical Toxicology (Licence: WI 31080) | |
| Enumeration Date | 2006-05-22 |
| Last Update Date | 2007-07-08 |