| NPI | 1558412122 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PT0002X Emergency Medicine, Medical Toxicology (Licence: AL 00019238) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AL 00019238) |
| 2083X0100X Preventive Medicine, Occupational Medicine (Licence: AL 00019238) | |
| Enumeration Date | 2007-01-12 |
| Last Update Date | 2007-07-08 |