| NPI | 1548886815 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NC 2023-01136) |
| Additional Taxonomies | 207PT0002X Emergency Medicine, Medical Toxicology (Licence: NC 2023-01136) |
| Enumeration Date | 2020-06-22 |
| Last Update Date | 2023-12-18 |