| NPI | 1841217700 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: ND 5572) |
| Additional Taxonomies | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: ND 5572) |
| 207PT0002X Emergency Medicine, Medical Toxicology (Licence: ND 5572) | |
| Enumeration Date | 2006-07-16 |
| Last Update Date | 2021-02-15 |