| NPI | 1275643447 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: WA MD00046832) |
| Additional Taxonomies | 2084A0401X Psychiatry & Neurology, Addiction Medicine (Licence: WA MD00046832) |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2024-06-28 |