| 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 |