| NPI | 1528363546 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WI 68666) |
| Additional Taxonomies | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: PA MT197286) |
| 207PT0002X Emergency Medicine, Medical Toxicology (Licence: WI 68666) | |
| Enumeration Date | 2011-01-22 |
| Last Update Date | 2022-11-04 |