| NPI | 1386938397 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA 135379) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: RI LP02315) |
| Enumeration Date | 2011-06-07 |
| Last Update Date | 2021-11-29 |