| NPI | 1144540451 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA 20A14158) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TX 503OL30907622) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MA 259107) | |
| Enumeration Date | 2010-06-09 |
| Last Update Date | 2015-09-24 |