| NPI | 1922049113 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA 20A9237) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: RI DO00669) |
| Enumeration Date | 2006-06-09 |
| Last Update Date | 2021-12-01 |