| NPI | 1518494988 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MA 286608) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: RI MD17975) |
| Enumeration Date | 2017-05-17 |
| Last Update Date | 2023-09-13 |