| NPI | 1780641712 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA G42150) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA G42150) |
| 207PH0002X Emergency Medicine, Hospice and Palliative Medicine (Licence: CA G42150) | |
| 208D00000X General Practice (Licence: CA G42150) | |
| 207RA0401X Internal Medicine, Addiction Medicine (Licence: CA G42150) | |
| 208VP0000X Pain Medicine, Pain Medicine (Licence: CA G42150) | |
| 207RH0002X Internal Medicine, Hospice and Palliative Medicine (Licence: CA G42150) | |
| 207NS0135X Dermatology, Procedural Dermatology (Licence: CA G42150) | |
| 202K00000X (Licence: CA G42150) | |
| 209800000X Legal Medicine (Licence: CA G42150) | |
| 207N00000X Dermatology (Licence: CA G42150) | |
| Enumeration Date | 2006-04-26 |
| Last Update Date | 2010-05-24 |