| NPI | 1225298946 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: RI MD13796) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: ME MD22694) |
| 207P00000X Emergency Medicine (Licence: RI LP01339) | |
| Enumeration Date | 2008-06-16 |
| Last Update Date | 2026-06-02 |