| NPI | 1558898270 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TX T2761) |
| Additional Taxonomies | 2084F0202X Psychiatry & Neurology, Forensic Psychiatry (Licence: TX T2761) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CO DR.0065329) | |
| 2084P0802X Psychiatry & Neurology, Addiction Psychiatry (Licence: TX T2761) | |
| Enumeration Date | 2017-05-11 |
| Last Update Date | 2023-07-17 |