| NPI | 1053677179 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TX P2753) |
| Additional Taxonomies | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: TX P2753) |
| 2084P0805X Psychiatry & Neurology, Geriatric Psychiatry (Licence: TX P2753) | |
| Enumeration Date | 2012-04-03 |
| Last Update Date | 2020-03-05 |