| NPI | 1568416485 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PT0002X Emergency Medicine, Medical Toxicology (Licence: CO 39721) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX M1018) |
| 207P00000X Emergency Medicine (Licence: CO 39721) | |
| 207PT0002X Emergency Medicine, Medical Toxicology (Licence: TX M1018) | |
| Enumeration Date | 2006-05-22 |
| Last Update Date | 2018-11-07 |