| NPI | 1780978304 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: WA MD70062150) |
| Additional Taxonomies | 2083A0300X Preventive Medicine, Addiction Medicine (Licence: WA MD70062150) |
| 2084F0202X Psychiatry & Neurology, Forensic Psychiatry (Licence: WA MD70062150) | |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: WA MD70062150) | |
| Enumeration Date | 2011-05-31 |
| Last Update Date | 2026-01-16 |