| NPI | 1881685576 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OH 35.143041) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MA 159310) |
| 207PT0002X Emergency Medicine, Medical Toxicology (Licence: MA 159310) | |
| Enumeration Date | 2005-11-02 |
| Last Update Date | 2024-10-18 |