| NPI | 1366515009 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: WA MD60524120) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MA 239248) |
| 2084P0805X Psychiatry & Neurology, Geriatric Psychiatry (Licence: MA 239248) | |
| 2084P0805X Psychiatry & Neurology, Geriatric Psychiatry (Licence: WA MD60524120) | |
| Enumeration Date | 2006-11-17 |
| Last Update Date | 2017-04-06 |