| NPI | 1598081788 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX Q3342)  | 
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NC 164559)  | 
| 207PT0002X Emergency Medicine, Medical Toxicology (Licence: TX Q3342)  | |
| Enumeration Date | 2010-04-13 | 
| Last Update Date | 2022-07-21 |