| NPI | 1407149628 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CT 73340) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: RI LP02243) |
| 207P00000X Emergency Medicine (Licence: TX Q2266) | |
| Enumeration Date | 2011-05-20 |
| Last Update Date | 2023-07-05 |