| NPI | 1700945417 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA 20A9465) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: CA 20A9465) |
| 208VP0000X Pain Medicine, Pain Medicine (Licence: CA 20A9465) | |
| 204D00000X Neuromusculoskeletal Medicine & OMM (Licence: CA 20A9465) | |
| 208D00000X General Practice (Licence: CA 20A9465) | |
| 202C00000X Independent Medical Examiner (Licence: CA 20A9465) | |
| 207RA0401X Internal Medicine, Addiction Medicine (Licence: CA 20A9465) | |
| 207Q00000X Family Medicine (Licence: CA 20a9465) | |
| 209800000X Legal Medicine (Licence: CA 20a9465) | |
| 2084A0401X Psychiatry & Neurology, Addiction Medicine (Licence: CA 20a9465) | |
| 2085U0001X Radiology, Diagnostic Ultrasound (Licence: CA 20a9465) | |
| Enumeration Date | 2006-12-08 |
| Last Update Date | 2015-05-10 |