| NPI | 1629201561 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA A124650) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TX FT45884) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TX R7618) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TX FT45449) | |
| Enumeration Date | 2009-08-26 |
| Last Update Date | 2021-05-19 |