| NPI | 1801864772 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MA 205253) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: RI MD12155) |
| 207P00000X Emergency Medicine (Licence: CT 56054) | |
| Enumeration Date | 2006-03-08 |
| Last Update Date | 2023-03-28 |