| NPI | 1609156645 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MA 1015347) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: RI DO00805) |
| 207P00000X Emergency Medicine (Licence: NY 275159) | |
| Enumeration Date | 2011-08-22 |
| Last Update Date | 2024-08-27 |