NPI | 1336274943 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: WA MD00026557) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: WA MD00026557) |
2084P0805X Psychiatry & Neurology, Geriatric Psychiatry (Licence: WA MD00026557) | |
Enumeration Date | 2007-02-22 |
Last Update Date | 2019-04-04 |