| NPI | 1174592158 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084F0202X Psychiatry & Neurology, Forensic Psychiatry (Licence: CA G34482) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: WA MD00025101) |
| 2084F0202X Psychiatry & Neurology, Forensic Psychiatry (Licence: WA MD00025101) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA G34482) | |
| Enumeration Date | 2006-03-14 |
| Last Update Date | 2012-07-05 |