| NPI | 1447411426 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: RI MD16718) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MA 247341) |
| Enumeration Date | 2008-06-22 |
| Last Update Date | 2019-07-03 |