| NPI | 1659420404 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA 20A18898) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NH 18409) |
| 207PT0002X Emergency Medicine, Medical Toxicology (Licence: MA 236596) | |
| 207PT0002X Emergency Medicine, Medical Toxicology (Licence: NH 18409) | |
| 207P00000X Emergency Medicine (Licence: MA 236596) | |
| Enumeration Date | 2007-01-10 |
| Last Update Date | 2021-11-11 |