| NPI | 1194883819 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: TX G9072) |
| Additional Taxonomies | 2084A0401X Psychiatry & Neurology Addiction Medicine (Licence: TX G9072) |
| 2084P0804X Psychiatry & Neurology Child & Adolescent Psychiatry (Licence: TX G9072) | |
| Enumeration Date | 2006-12-05 |
| Last Update Date | 2020-01-03 |