| NPI | 1962443382 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TX E6078) |
| Additional Taxonomies | 2084P0802X Psychiatry & Neurology, Addiction Psychiatry (Licence: TX E6078) |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: TX E6078) | |
| 2084P0805X Psychiatry & Neurology, Geriatric Psychiatry (Licence: TX E6078) | |
| Enumeration Date | 2006-06-09 |
| Last Update Date | 2007-12-26 |