| NPI | 1427154038 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: CA A85105) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA A85105) |
| 207RA0401X Internal Medicine, Addiction Medicine (Licence: CA A85105) | |
| 208VP0000X Pain Medicine, Pain Medicine (Licence: CA A85105) | |
| Enumeration Date | 2006-09-15 |
| Last Update Date | 2015-01-18 |