| NPI | 1013995471 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: WA MD00040860) |
| Additional Taxonomies | 2084F0202X Psychiatry & Neurology Forensic Psychiatry (Licence: NE 26951) |
| 2084F0202X Psychiatry & Neurology Forensic Psychiatry (Licence: MN 42929) | |
| 2084P0800X Psychiatry & Neurology Psychiatry (Licence: NE 26951) | |
| 2084P0804X Psychiatry & Neurology Child & Adolescent Psychiatry (Licence: WA MD00040860) | |
| 2084P0805X Psychiatry & Neurology Geriatric Psychiatry (Licence: WA MD00040860) | |
| 2084F0202X Psychiatry & Neurology Forensic Psychiatry (Licence: WA MD00040860) | |
| Enumeration Date | 2006-01-05 |
| Last Update Date | 2020-07-02 |