| NPI | 1467645283 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TX P5329) |
| Additional Taxonomies | 251B00000X Case Management (Licence: TX P5329) |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: TX P5329) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX P5329) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CT 04703) | |
| Enumeration Date | 2007-08-24 |
| Last Update Date | 2026-06-15 |