| NPI | 1912988023 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PT0002X Emergency Medicine, Medical Toxicology (Licence: MI 4301078635) |
| Additional Taxonomies | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: MI 4301078635) |
| 207L00000X Anesthesiology (Licence: MI 4301078635) | |
| 207P00000X Emergency Medicine (Licence: MI 4301078635) | |
| Enumeration Date | 2005-11-07 |
| Last Update Date | 2025-02-20 |