| NPI | 1841274560 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CT 033738) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: RI CMD16915) |
| Enumeration Date | 2005-12-06 |
| Last Update Date | 2020-03-05 |