| NPI | 1609001577 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: WA MD60227512) |
| Additional Taxonomies | 2084A0401X Psychiatry & Neurology, Addiction Medicine (Licence: WA MD60227512) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2009-05-21 |
| Last Update Date | 2021-07-14 |