| NPI | 1649414301 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: WA md00041348) |
| Additional Taxonomies | 2084F0202X Psychiatry & Neurology, Forensic Psychiatry (Licence: CA A106795) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA A106795) | |
| 2084F0202X Psychiatry & Neurology, Forensic Psychiatry (Licence: WA md00041348) | |
| Enumeration Date | 2009-04-26 |
| Last Update Date | 2010-04-14 |