| NPI | 1912910001 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: RI MD16967) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AZ 42875) |
| 207P00000X Emergency Medicine (Licence: MA 213490) | |
| Enumeration Date | 2006-08-13 |
| Last Update Date | 2020-07-16 |