| NPI | 1982950879 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: RI MD15965) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 290182) |
| 207P00000X Emergency Medicine (Licence: MA MD15965) | |
| Enumeration Date | 2012-07-28 |
| Last Update Date | 2021-02-10 |