| NPI | 1558865758 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA A164485)  | 
| Additional Taxonomies | 207PT0002X Emergency Medicine, Medical Toxicology (Licence: CA A164485)  | 
| 207RA0401X Internal Medicine, Addiction Medicine (Licence: CA A164485)  | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-03-21 | 
| Last Update Date | 2024-10-17 |