| NPI | 1891776167 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084F0202X Psychiatry & Neurology, Forensic Psychiatry (Licence: TX H9331) |
| Additional Taxonomies | 2084A0401X Psychiatry & Neurology, Addiction Medicine (Licence: TX H9331) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TX H9331) | |
| Enumeration Date | 2005-11-14 |
| Last Update Date | 2025-09-11 |