| NPI | 1831240894 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: WA 60419703) |
| Enumeration Date | 2007-01-16 |
| Last Update Date | 2017-03-08 |