| NPI | 1821655671 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA A185092) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: RI LP04513) |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: CA A185092) | |
| Enumeration Date | 2019-05-28 |
| Last Update Date | 2025-08-01 |