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 |