| NPI | 1760793830 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207PT0002X Emergency Medicine, Medical Toxicology (Licence: PA MD446624) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MT196909) |
| 207P00000X Emergency Medicine (Licence: PA MD446624) | |
| 2083A0300X Preventive Medicine, Addiction Medicine (Licence: PA MD446624) | |
| Enumeration Date | 2010-06-23 |
| Last Update Date | 2025-08-26 |