| NPI | 1356503155 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: RI MD18611) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 261286) |
| Enumeration Date | 2008-07-02 |
| Last Update Date | 2026-02-12 |