| NPI | 1477746675 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: CO DR.0064896) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: WA ML20009087) |
| 2084P0800X Psychiatry & Neurology Psychiatry (Licence: CA A116861) | |
| Enumeration Date | 2007-08-21 |
| Last Update Date | 2022-10-10 |