NPI | 1467658930 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084F0202X Psychiatry & Neurology, Forensic Psychiatry (Licence: TX Q0720) |
Additional Taxonomies | 2084P0301X Psychiatry & Neurology, Brain Injury Medicine (Licence: TX Q0270) |
2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TX Q0720) | |
Enumeration Date | 2007-06-22 |
Last Update Date | 2019-10-12 |