| NPI | 1427602218 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: VT 042-0017020) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 323403) |
| 207P00000X Emergency Medicine (Licence: RI CLP04733) | |
| 207P00000X Emergency Medicine (Licence: RI LP04733) | |
| Enumeration Date | 2019-07-30 |
| Last Update Date | 2023-08-11 |