| NPI | 1144263336 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: RI MD07813) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: RI MD7813) |
| Enumeration Date | 2006-06-14 |
| Last Update Date | 2013-09-16 |