| NPI | 1316262645 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: VA 0102203754) |
| Additional Taxonomies | 2084B0040X Psychiatry & Neurology, Behavioral Neurology & Neuropsychiatry (Licence: TX Q1384) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: WA OP61249953) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MI 5101028172) | |
| 2084P0802X Psychiatry & Neurology, Addiction Psychiatry (Licence: TX Q1384) | |
| 2084A0401X Psychiatry & Neurology, Addiction Medicine (Licence: TX Q1384) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: AK 200642) | |
| Enumeration Date | 2010-03-30 |
| Last Update Date | 2026-08-04 |