| NPI | 1275530990 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0805X Psychiatry & Neurology, Geriatric Psychiatry (Licence: WA OP61001066) |
| Additional Taxonomies | 2084B0040X Psychiatry & Neurology, Behavioral Neurology & Neuropsychiatry (Licence: WA OP61001066) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: WA OP61001066) | |
| Enumeration Date | 2005-07-07 |
| Last Update Date | 2019-11-20 |