| NPI | 1669589511 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: RI MD05667) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: RI RI005667) |
| 207P00000X Emergency Medicine (Licence: CT 053897) | |
| Enumeration Date | 2006-08-25 |
| Last Update Date | 2015-07-07 |