| NPI | 1831239722 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: RI MD09907) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: KS 0428139) |
| Enumeration Date | 2007-02-08 |
| Last Update Date | 2014-06-05 |