| NPI | 1134219116 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TX P1833) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX P1833) |
| 2084P0301X Psychiatry & Neurology, Brain Injury Medicine (Licence: TX P1833) | |
| 2084P0802X Psychiatry & Neurology, Addiction Psychiatry (Licence: TX P1833) | |
| 2084F0202X Psychiatry & Neurology, Forensic Psychiatry (Licence: TX P1833) | |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2026-03-13 |