| NPI | 1518301191 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: RI MD15911) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 283566) |
| Enumeration Date | 2013-04-25 |
| Last Update Date | 2026-03-17 |