| NPI | 1740693472 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: KS 04-42268) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OR MD182028) |
| 207P00000X Emergency Medicine (Licence: MO 2020012812) | |
| 207PT0002X Emergency Medicine Medical Toxicology (Licence: KS 04-42268) | |
| 207PT0002X Emergency Medicine Medical Toxicology (Licence: MO 2020012812) | |
| Enumeration Date | 2014-06-10 |
| Last Update Date | 2022-03-07 |