| NPI | 1841452893 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX P0089) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: ME MD19409) |
| 207P00000X Emergency Medicine (Licence: VA 0101274404) | |
| 207PT0002X Emergency Medicine, Medical Toxicology (Licence: VA 0101274404) | |
| Enumeration Date | 2008-07-01 |
| Last Update Date | 2023-01-09 |