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 |