| NPI | 1821542671 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MA 291756) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: RI LP04353) |
| Enumeration Date | 2016-08-10 |
| Last Update Date | 2022-07-01 |