| NPI | 1447310776 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX N8515) |
| Additional Taxonomies | 2084P0802X Psychiatry & Neurology, Addiction Psychiatry (Licence: TX N8515) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX N8515) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TX N8515) | |
| Enumeration Date | 2006-12-08 |
| Last Update Date | 2025-12-23 |