| NPI | 1952397861 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207PT0002X Emergency Medicine, Medical Toxicology (Licence: TX P4572) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX P4572) |
| Enumeration Date | 2005-09-26 |
| Last Update Date | 2021-01-04 |