| NPI | 1679985105 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207PT0002X Emergency Medicine, Medical Toxicology (Licence: TN 60714) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA A154633) |
| 207P00000X Emergency Medicine (Licence: PA mt206041) | |
| 207P00000X Emergency Medicine (Licence: TN 60714) | |
| 207PT0002X Emergency Medicine, Medical Toxicology (Licence: CA A154633) | |
| Enumeration Date | 2014-06-02 |
| Last Update Date | 2024-05-15 |