| NPI | 1912944620 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: HI MD-20623) |
| Additional Taxonomies | 2084F0202X Psychiatry & Neurology, Forensic Psychiatry (Licence: HI MD-20623) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TX F9260) | |
| 2084P0802X Psychiatry & Neurology, Addiction Psychiatry (Licence: HI MD-20623) | |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: HI MD-20623) | |
| Enumeration Date | 2006-06-01 |
| Last Update Date | 2023-01-20 |