| NPI | 1013470079 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084F0202X Psychiatry & Neurology Forensic Psychiatry (Licence: WA OP61409279) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: CT 069432) |
| 2084P0800X Psychiatry & Neurology Psychiatry (Licence: WA OP61409279) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2019-04-08 |
| Last Update Date | 2024-04-11 |