| NPI | 1700248846 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: RI LP04878) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: ME MD22753) |
| Enumeration Date | 2016-03-28 |
| Last Update Date | 2020-06-29 |