| NPI | 1114988235 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CT 41297) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: RI MD17411) |
| Enumeration Date | 2006-03-29 |
| Last Update Date | 2020-12-16 |