| NPI | 1477683696 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MI 4301083429) |
| Additional Taxonomies | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: MI 4301083429) |
| 207PT0002X Emergency Medicine, Medical Toxicology (Licence: MI 4301083429) | |
| Enumeration Date | 2007-03-06 |
| Last Update Date | 2010-07-01 |