| NPI | 1790774073 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: RI MD10478) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CT 034430) |
| Enumeration Date | 2005-10-19 |
| Last Update Date | 2008-08-20 |