| NPI | 1790340784 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PT0002X Emergency Medicine, Medical Toxicology (Licence: AZ 65525) |
| Additional Taxonomies | 207PT0002X Emergency Medicine, Medical Toxicology (Licence: TX T2807) |
| 207P00000X Emergency Medicine (Licence: TX T2807) | |
| Enumeration Date | 2019-05-06 |
| Last Update Date | 2024-07-23 |