| NPI | 1316953458 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: RI MD 09381) |
| Additional Taxonomies | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: MA 58081) |
| 207P00000X Emergency Medicine (Licence: MA 58081) | |
| Enumeration Date | 2006-07-31 |
| Last Update Date | 2023-05-09 |