| NPI | 1801885306 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TX G9772) |
| Additional Taxonomies | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: TX G9772) |
| 2084P0805X Psychiatry & Neurology, Geriatric Psychiatry (Licence: TX G9772) | |
| Enumeration Date | 2005-10-18 |
| Last Update Date | 2016-06-14 |