| NPI | 1891719712 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: KY C1665) |
| Additional Taxonomies | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: RI MD12086) |
| 207R00000X Internal Medicine (Licence: RI MD12086) | |
| 207P00000X Emergency Medicine (Licence: CO DR.0063634) | |
| 207P00000X Emergency Medicine (Licence: RI MD06899) | |
| 207P00000X Emergency Medicine (Licence: NE CP1117) | |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2025-01-15 |