| NPI | 1063777860 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TX 44743) |
| Additional Taxonomies | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: VA 0116025230) |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: TX 44743) | |
| Enumeration Date | 2012-07-08 |
| Last Update Date | 2015-03-02 |