| NPI | 1225529340 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CT 70008) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: RI LP04257) |
| Enumeration Date | 2018-05-24 |
| Last Update Date | 2023-02-19 |