| NPI | 1669962841 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA OS022091) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: RI LP04422) |
| Enumeration Date | 2018-05-14 |
| Last Update Date | 2022-06-02 |