| NPI | 1487740122 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: ME 014140) |
| Additional Taxonomies | 207PT0002X Emergency Medicine, Medical Toxicology (Licence: CT 045057) |
| 207P00000X Emergency Medicine (Licence: CT 045057) | |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2007-07-08 |