| NPI | 1164797494 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: MA 274831) |
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: MA 274831) |
| 207LC0200X Anesthesiology, Critical Care Medicine (Licence: FL ME126932) | |
| 207P00000X Emergency Medicine (Licence: MA 274831) | |
| 207P00000X Emergency Medicine (Licence: RI MD16994) | |
| Enumeration Date | 2012-03-20 |
| Last Update Date | 2025-09-23 |