| NPI | 1225483936 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: RI MD20117) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: GA 82034) |
| 207P00000X Emergency Medicine (Licence: MA 1018415) | |
| Enumeration Date | 2016-05-01 |
| Last Update Date | 2025-08-01 |