| NPI | 1568601870 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PT0002X Emergency Medicine Medical Toxicology (Licence: SC SC 36202) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: VA 0102203084) |
| 207P00000X Emergency Medicine (Licence: WV 2421) | |
| 207PT0002X Emergency Medicine Medical Toxicology (Licence: VA 0102203084) | |
| 207PT0002X Emergency Medicine Medical Toxicology (Licence: WV 2421) | |
| Enumeration Date | 2009-02-10 |
| Last Update Date | 2021-09-21 |