| NPI | 1326083643 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0005X Psychiatry & Neurology, Neurodevelopmental Disabilities (Licence: TX M9885) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TX M9885) |
| 2084P0805X Psychiatry & Neurology, Geriatric Psychiatry (Licence: TX M9885) | |
| Enumeration Date | 2006-06-19 |
| Last Update Date | 2021-06-30 |