| NPI | 1699295816 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: RI MD17780) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: RI LP04093) |
| Enumeration Date | 2017-06-20 |
| Last Update Date | 2022-02-17 |