| NPI | 1467619825 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: RI DO00642) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 243253) |
| Enumeration Date | 2008-05-21 |
| Last Update Date | 2021-12-17 |