| NPI | 1053675090 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TX V2519) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT-202583) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: SC 91831) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: HI 23678) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: KY 56784) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: OH 35.142699) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: GA 88018) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: GA 10096) | |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: TX V2519) | |
| Enumeration Date | 2012-06-25 |
| Last Update Date | 2024-09-11 |