| NPI | 1538729066 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: AR E-19602) | 
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA OT019423) | 
| 207PT0002X Emergency Medicine, Medical Toxicology (Licence: AR E-19602) | |
| 207P00000X Emergency Medicine (Licence: AZ 010714) | |
| Enumeration Date | 2019-06-17 | 
| Last Update Date | 2025-10-02 |