| NPI | 1063565737 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NC 2015-00696) |
| Additional Taxonomies | 2084F0202X Psychiatry & Neurology, Forensic Psychiatry (Licence: TX H9768) |
| 2084P2900X Psychiatry & Neurology, Pain Medicine (Licence: TX H9768) | |
| 2084F0202X Psychiatry & Neurology, Forensic Psychiatry (Licence: NC 2015-00696) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TX H9768) | |
| 2084P0802X Psychiatry & Neurology, Addiction Psychiatry (Licence: TX H9768) | |
| 2084P0805X Psychiatry & Neurology, Geriatric Psychiatry (Licence: TX H9768) | |
| Enumeration Date | 2007-01-18 |
| Last Update Date | 2022-12-07 |