| NPI | 1811125073 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: RI MD18464) |
| Additional Taxonomies | 207PE0005X Emergency Medicine Undersea and Hyperbaric Medicine (Licence: RI MD18464) |
| Enumeration Date | 2009-06-26 |
| Last Update Date | 2024-07-12 |