| NPI | 1033735584 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MA 1017581) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: RI LP05093) |
| Enumeration Date | 2020-06-21 |
| Last Update Date | 2024-03-27 |