| NPI | 1336465806 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TX P4877) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: VA 0101259486) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TX BP1-0036626) | |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: HI MD18375) | |
| Enumeration Date | 2010-04-08 |
| Last Update Date | 2023-07-13 |