| NPI | 1962604785 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: RI MD13314) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: RI LP01167) |
| Enumeration Date | 2007-06-04 |
| Last Update Date | 2023-12-01 |