| NPI | 1578579678 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: RI MD07004) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: ME MD18266) |
| Enumeration Date | 2006-07-31 |
| Last Update Date | 2022-10-13 |