| NPI | 1407143282 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: RI MD15466) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MO 2011019422) |
| Enumeration Date | 2011-06-30 |
| Last Update Date | 2016-07-05 |