| NPI | 1699839654 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PT0002X Emergency Medicine, Medical Toxicology (Licence: NE 24931) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MA 75759) |
| Enumeration Date | 2006-12-21 |
| Last Update Date | 2014-11-05 |