| NPI | 1497191803 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NC 2021-01643) | 
| Additional Taxonomies | 207PT0002X Emergency Medicine, Medical Toxicology (Licence: NC 2021-01643) | 
| Enumeration Date | 2013-05-14 | 
| Last Update Date | 2024-07-15 |