| NPI | 1861656886 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: ME MD19695) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: RI LP01503) |
| 207P00000X Emergency Medicine (Licence: MA 250207) | |
| Enumeration Date | 2008-07-18 |
| Last Update Date | 2013-09-16 |