| NPI | 1114213410 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: RI DO00794) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: RI LP02205) |
| 207P00000X Emergency Medicine (Licence: MA 258918) | |
| Enumeration Date | 2011-06-24 |
| Last Update Date | 2015-04-28 |