| NPI | 1134219116 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TX P1833) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX P1833) |
| 207R00000X Internal Medicine (Licence: TX P1833) | |
| 2084P0802X Psychiatry & Neurology, Addiction Psychiatry (Licence: TX P1833) | |
| 2084A0401X Psychiatry & Neurology, Addiction Medicine (Licence: TX P1833) | |
| 2084F0202X Psychiatry & Neurology, Forensic Psychiatry (Licence: TX P1833) | |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2021-07-23 |