| NPI | 1174883110 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MA 261096) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: RI MD15286) |
| 207P00000X Emergency Medicine (Licence: RI LP02484) | |
| Enumeration Date | 2012-05-24 |
| Last Update Date | 2020-09-22 |