| NPI | 1497816649 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: WA 023511) |
| Additional Taxonomies | 2084F0202X Psychiatry & Neurology, Forensic Psychiatry (Licence: WA 023511) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: WA 023511) | |
| Enumeration Date | 2006-12-12 |
| Last Update Date | 2016-12-01 |