| NPI | 1760046833 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MA 292085) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: RI MD21273) |
| 207P00000X Emergency Medicine (Licence: DE C1-0027192) | |
| Enumeration Date | 2019-04-24 |
| Last Update Date | 2026-04-09 |