| NPI | 1700374139 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NC 2023-02195) |
| Additional Taxonomies | 207PT0002X Emergency Medicine, Medical Toxicology (Licence: VA 0101272708) |
| Enumeration Date | 2018-05-01 |
| Last Update Date | 2024-02-27 |