| NPI | 1225080617 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080A0000X Pediatrics, Adolescent Medicine (Licence: RI MD03912) |
| Additional Taxonomies | 146D00000X Personal Emergency Response Attendant (Licence: RI md03912) |
| Enumeration Date | 2006-05-16 |
| Last Update Date | 2025-09-11 |