| NPI | 1821677253 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: ID 2271357) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: RI LP05276) |
| Enumeration Date | 2021-04-04 |
| Last Update Date | 2025-06-05 |