| NPI | 1831161876 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: TX N817) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TX N8170) |
| 2084P0802X Psychiatry & Neurology, Addiction Psychiatry (Licence: TX N817) | |
| Enumeration Date | 2006-02-03 |
| Last Update Date | 2013-05-16 |