| NPI | 1558352203 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: UT 5560815-1205) |
| Additional Taxonomies | 207PT0002X Emergency Medicine, Medical Toxicology (Licence: WA MD 60148992) |
| Enumeration Date | 2005-11-02 |
| Last Update Date | 2023-04-20 |