| NPI | 1194940973 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX P4379) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: RI LP00449) |
| 207P00000X Emergency Medicine (Licence: RI MD13025) | |
| 207P00000X Emergency Medicine (Licence: PA MD440167) | |
| Enumeration Date | 2007-04-16 |
| Last Update Date | 2012-11-13 |