| NPI | 1972767986 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TX Q2227) |
| Additional Taxonomies | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: TX Q2227) |
| 2084A0401X Psychiatry & Neurology, Addiction Medicine (Licence: TX Q2227) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MO 2011027713) | |
| Enumeration Date | 2008-07-18 |
| Last Update Date | 2024-04-29 |