| NPI | 1386783785 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TX T3294) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA A97056) |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: TX T3294) | |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: CA A97056) | |
| Enumeration Date | 2007-02-05 |
| Last Update Date | 2024-08-05 |