NPI | 1225356678 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA 71854) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA 343083) |
2084P2900X Psychiatry & Neurology, Pain Medicine (Licence: CA 456) | |
Enumeration Date | 2010-05-10 |
Last Update Date | 2024-04-01 |