| NPI | 1275609943 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0805X (Licence: TX H4198) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TX H4198) |
| Enumeration Date | 2006-11-27 |
| Last Update Date | 2025-09-11 |