| NPI | 1548214141 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: RI MD07817) |
| Additional Taxonomies | 208VP0000X Pain Medicine Pain Medicine (Licence: RI MD07817) |
| Enumeration Date | 2006-05-19 |
| Last Update Date | 2018-03-19 |