| 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: WA MD00047712) | |
| 2084F0202X Psychiatry & Neurology Forensic Psychiatry | |
| Enumeration Date | 2007-12-31 |
| Last Update Date | 2007-12-31 |