| NPI | 1588762413 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OR MD16181) |
| Additional Taxonomies | 207PE0004X Emergency Medicine Emergency Medical Services (Licence: OR MD16181) |
| 207PP0204X Emergency Medicine Pediatric Emergency Medicine (Licence: OR MD16181) | |
| 207PT0002X Emergency Medicine Medical Toxicology (Licence: OR MD16181) | |
| Enumeration Date | 2006-09-21 |
| Last Update Date | 2007-07-08 |