| NPI | 1598227373 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PT0002X Emergency Medicine Medical Toxicology (Licence: OR MD218709) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MA 291462) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2019-04-02 |
| Last Update Date | 2024-07-05 |