| NPI | 1780923557 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NH 20580) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: RI DO01109) |
| Enumeration Date | 2013-02-13 |
| Last Update Date | 2021-08-18 |