| NPI | 1629338132 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207PT0002X Emergency Medicine, Medical Toxicology (Licence: PA OS017664) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA OS017664) |
| Enumeration Date | 2012-05-18 |
| Last Update Date | 2020-04-14 |