| NPI | 1558749309 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: RI CMD16651) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: RI LPO3292) |
| Enumeration Date | 2015-05-13 |
| Last Update Date | 2019-10-23 |