| NPI | 1205875440 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: RI MD 09560) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CT 53114) |
| Enumeration Date | 2006-06-05 |
| Last Update Date | 2020-02-27 |