| NPI | 1801231089 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: GA 83794) |
| Additional Taxonomies | 207PT0002X Emergency Medicine, Medical Toxicology (Licence: GA 83794) |
| 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: NY 281791) | |
| Enumeration Date | 2013-05-01 |
| Last Update Date | 2021-07-29 |