| NPI | 1619901147 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: RI DO00356) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: ME DO2808) |
| 207P00000X Emergency Medicine (Licence: RI DO 00356) | |
| 207P00000X Emergency Medicine (Licence: MA 74935) | |
| 207QA0401X Family Medicine Addiction Medicine (Licence: RI DO00356) | |
| 2084A0401X Psychiatry & Neurology Addiction Medicine (Licence: RI DO00356) | |
| Enumeration Date | 2006-07-10 |
| Last Update Date | 2022-12-13 |