| NPI | 1508082652 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TX G1593) |
| Additional Taxonomies | 2084P0015X Psychiatry & Neurology, Psychosomatic Medicine (Licence: TX G1593) |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: TX G1593) | |
| Enumeration Date | 2007-04-17 |
| Last Update Date | 2023-10-24 |