| NPI | 1669852653 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: RI MD16561) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MA 273543) |
| Enumeration Date | 2015-06-04 |
| Last Update Date | 2019-07-05 |