| NPI | 1700971330 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: VT 042.0012502) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CT 040475) |
| 207PT0002X Emergency Medicine, Medical Toxicology (Licence: CT 040475) | |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2021-05-04 |