| NPI | 1134124639 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: WA MD00044964) |
| Additional Taxonomies | 207RH0002X Internal Medicine, Hospice and Palliative Medicine (Licence: WA MD00044964) |
| Enumeration Date | 2005-06-20 |
| Last Update Date | 2014-06-12 |