| NPI | 1558376129 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MA 212548) |
| Additional Taxonomies | 207PT0002X Emergency Medicine, Medical Toxicology (Licence: MA 212548) |
| Enumeration Date | 2006-07-30 |
| Last Update Date | 2013-01-13 |