| NPI | 1538142328 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CT 34668) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: RI MD09664) |
| Enumeration Date | 2005-11-25 |
| Last Update Date | 2023-05-15 |