NPI | 1629021365 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0805X Psychiatry & Neurology, Geriatric Psychiatry (Licence: CA A84559) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA A84559) |
2084P2900X Psychiatry & Neurology, Pain Medicine (Licence: CA A84559) | |
Enumeration Date | 2006-05-17 |
Last Update Date | 2017-12-30 |