| NPI | 1710159124 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084A0401X Psychiatry & Neurology Addiction Medicine (Licence: CA G49142) |
| Additional Taxonomies | 2083P0901X Preventive Medicine Public Health & General Preventive Medicine (Licence: CA G49142) |
| 2084N0600X Psychiatry & Neurology Clinical Neurophysiology (Licence: CA G49142) | |
| 2084P0802X Psychiatry & Neurology Addiction Psychiatry (Licence: CA G49142) | |
| 2084P2900X Psychiatry & Neurology Pain Medicine (Licence: CA G49142) | |
| 208U00000X Clinical Pharmacology (Licence: CA G49142) | |
| 209800000X Legal Medicine (Licence: CA G49142) | |
| Enumeration Date | 2008-03-25 |
| Last Update Date | 2008-03-25 |