| NPI | 1295950277 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MN 56611) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: RI MD13269) |
| 207P00000X Emergency Medicine (Licence: RI LP00808) | |
| 207P00000X Emergency Medicine (Licence: MN 106826) | |
| Enumeration Date | 2007-04-16 |
| Last Update Date | 2020-10-08 |