| NPI | 1427166388 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TX 44409) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NC 2009-01083) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: NC 2009-01083) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: SC 21920) | |
| Enumeration Date | 2006-08-29 |
| Last Update Date | 2019-10-21 |