| NPI | 1538781273 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: RI MD19670) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 4301508707) |
| 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: RI MD19670) | |
| Enumeration Date | 2020-05-16 |
| Last Update Date | 2024-06-14 |