| NPI | 1225300635 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine (Licence: CA G52483) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA G52483) |
| 207LA0401X Anesthesiology, Addiction Medicine (Licence: CA G52483) | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: CA G52483) | |
| 207RA0401X Internal Medicine, Addiction Medicine (Licence: CA G52483) | |
| 208100000X Physical Medicine & Rehabilitation (Licence: CA G52483) | |
| 2084A0401X Psychiatry & Neurology, Addiction Medicine (Licence: CA G52483) | |
| 2084P0802X Psychiatry & Neurology, Addiction Psychiatry (Licence: CA G52483) | |
| 2084P2900X Psychiatry & Neurology, Pain Medicine (Licence: CA G52483) | |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: CA G52483) | |
| 374K00000X Religious Nonmedical Practitioner (Licence: CA G52483) | |
| Enumeration Date | 2012-01-31 |
| Last Update Date | 2024-06-22 |