| NPI | 1710908611 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MA 231864) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: RI MD12153) |
| Enumeration Date | 2006-07-23 |
| Last Update Date | 2022-06-01 |