| NPI | 1144678103 |
|---|---|
| Former Name | A N |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: WA MD61257318) |
| Additional Taxonomies | 208D00000X General Practice (Licence: WA MD61257318) |
| Enumeration Date | 2016-06-01 |
| Last Update Date | 2024-01-11 |