| NPI | 1629415567 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OR MD176626) |
| Additional Taxonomies | 207PT0002X Emergency Medicine, Medical Toxicology (Licence: UT 10814527-1205) |
| Enumeration Date | 2013-06-02 |
| Last Update Date | 2021-11-08 |