| NPI | 1083355879 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA A198652) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: RI MD20843) |
| Enumeration Date | 2022-04-05 |
| Last Update Date | 2025-10-02 |