| NPI | 1063679017 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA A113239) |
| Additional Taxonomies | 2084A0401X Psychiatry & Neurology, Addiction Medicine (Licence: CA A113239) |
| 2084P0015X Psychiatry & Neurology, Psychosomatic Medicine (Licence: CA A113239) | |
| 2084P2900X Psychiatry & Neurology, Pain Medicine (Licence: CA A113239) | |
| Enumeration Date | 2008-05-19 |
| Last Update Date | 2024-02-13 |