| NPI | 1245518786 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TX Q1716)  | 
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: UT 12805519-1235)  | 
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: ID MC-1384)  | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NE CP839)  | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CO CDR0002235)  | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 270630)  | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: OK OK40548)  | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: WY 14418C)  | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IA MD48295)  | |
| Enumeration Date | 2011-08-02 | 
| Last Update Date | 2025-04-21 |