| NPI | 1578975306 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: RI MD16225) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: RI LP03050) |
| Enumeration Date | 2014-05-28 |
| Last Update Date | 2018-04-09 |