| NPI | 1578719704 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: ME MD23807) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MA 250461) |
| 207P00000X Emergency Medicine (Licence: CT 052572) | |
| 207PT0002X Emergency Medicine, Medical Toxicology (Licence: ME MD23807) | |
| 207PT0002X Emergency Medicine, Medical Toxicology (Licence: MA 250461) | |
| Enumeration Date | 2008-08-07 |
| Last Update Date | 2021-10-29 |