| NPI | 1609049071 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: WA MD60229798) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA A80148) |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: CA A80148) | |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: WA MD60229798) | |
| Enumeration Date | 2008-04-08 |
| Last Update Date | 2019-07-01 |