| NPI | 1366795635 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LULUMAFUIE FIATOA Chief Medical Officer 888-589-2259 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: HI MD5016) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: HI MD5016) |
| 208VP0000X Pain Medicine, Pain Medicine (Licence: HI 14877) | |
| Enumeration Date | 2012-10-23 |
| Last Update Date | 2012-10-23 |