| NPI | 1114073913 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA G-46028) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NM MD2014-0518) |
| 2084P2900X Psychiatry & Neurology, Pain Medicine (Licence: HI MD-11569) | |
| 2084P2900X Psychiatry & Neurology, Pain Medicine (Licence: AL MD30799) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: AL MD30799) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: AZ 48723) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: AR R-4145) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: HI MD-11569) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NV 5372) | |
| Enumeration Date | 2007-01-25 |
| Last Update Date | 2020-12-04 |