| NPI | 1538344270 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA G054196)  | 
| Additional Taxonomies | 2084F0202X Psychiatry & Neurology, Forensic Psychiatry (Licence: CA G054196)  | 
| 2084F0202X Psychiatry & Neurology, Forensic Psychiatry (Licence: IL 036096123)  | |
| 2084F0202X Psychiatry & Neurology, Forensic Psychiatry (Licence: WA MD00047712)  | |
| Enumeration Date | 2007-12-31 | 
| Last Update Date | 2007-12-31 |