| NPI | 1275043911 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA 18334) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: RI DO00913) |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: CA 18334) | |
| Enumeration Date | 2017-10-09 |
| Last Update Date | 2025-07-29 |