| NPI | 1568452704 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A41695) |
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: CA A41695) |
| 208600000X Surgery (Licence: CA A41695) | |
| 208M00000X Hospitalist (Licence: CA A41695) | |
| 208VP0000X Pain Medicine, Pain Medicine (Licence: CA A41695) | |
| 209800000X Legal Medicine (Licence: CA A41695) | |
| Enumeration Date | 2005-10-27 |
| Last Update Date | 2017-11-18 |