| NPI | 1265666911 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TX Q2061) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: VA 0101254873) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: WA MD60869375) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MN 63932) | |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: WA MD60869375) | |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: VA 0101254873) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: OR MD175575) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: WI 161-320) | |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: TX Q2061) | |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: MN 63932) | |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: OR MD175575) | |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: WI 161-320) | |
| Enumeration Date | 2009-05-11 |
| Last Update Date | 2019-04-16 |