| NPI | 1801026752 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MI 4301097021) |
| Additional Taxonomies | 207PT0002X Emergency Medicine, Medical Toxicology (Licence: PA 193697) |
| Enumeration Date | 2009-07-24 |
| Last Update Date | 2021-03-01 |