| NPI | 1477560803 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: KS 04-31362) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MO 2005011352) |
| 207P00000X Emergency Medicine (Licence: CA A80775) | |
| 207PT0002X Emergency Medicine, Medical Toxicology (Licence: KS 04-31362) | |
| 207PT0002X Emergency Medicine, Medical Toxicology (Licence: MO 2005011352) | |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2019-07-08 |