| NPI | 1194088591 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: OR PG157911) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: WA OP61465088) |
| Enumeration Date | 2012-06-20 |
| Last Update Date | 2024-05-29 |