| NPI | 1245268713 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: FL ACN1307) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: PR 16307) |
| 2084P0804X Psychiatry & Neurology Child & Adolescent Psychiatry (Licence: PR 16307) | |
| 208D00000X General Practice (Licence: PR 16307) | |
| Enumeration Date | 2006-06-30 |
| Last Update Date | 2021-10-08 |