| NPI | 1144269986 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: RI MD05562) |
| Additional Taxonomies | 208VP0000X Pain Medicine, Pain Medicine (Licence: RI MD05562) |
| 207P00000X Emergency Medicine (Licence: RI MD05562) | |
| Enumeration Date | 2006-06-06 |
| Last Update Date | 2014-02-11 |