| NPI | 1578722039 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX P7305) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CO 50473) |
| 207PT0002X Emergency Medicine, Medical Toxicology (Licence: TX P7305) | |
| Enumeration Date | 2008-06-09 |
| Last Update Date | 2019-09-17 |