NPI | 1841283793 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: WA MD00028756) |
Additional Taxonomies | 208D00000X General Practice (Licence: WA MD00028756) |
Enumeration Date | 2005-08-25 |
Last Update Date | 2014-06-13 |