| NPI | 1144263179 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CO 47648) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CO 47548) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: KY 35559) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IN 01060017A) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TX K7211B) | |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: CO 47648) | |
| Enumeration Date | 2006-06-14 |
| Last Update Date | 2023-04-10 |