| NPI | 1649664913 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: VT 042-0015348) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IL 036.148262) |
| 207PT0002X Emergency Medicine, Medical Toxicology (Licence: IL 036.148262) | |
| 207P00000X Emergency Medicine (Licence: NY 310427) | |
| Enumeration Date | 2015-03-25 |
| Last Update Date | 2025-10-09 |