| NPI | 1033401518 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: WA OP60985565) |
| Additional Taxonomies | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: TN 2641) |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: WI 57680-21) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TN 2641) | |
| Enumeration Date | 2011-05-03 |
| Last Update Date | 2024-09-17 |