| NPI | 1437562444 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: RI MD16290) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: RI LP03113) |
| Enumeration Date | 2014-06-06 |
| Last Update Date | 2018-06-28 |