| NPI | 1841633732 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: WA MD61042709) |
| Additional Taxonomies | 2084F0202X Psychiatry & Neurology, Forensic Psychiatry (Licence: AR E-10068) |
| 2084F0202X Psychiatry & Neurology, Forensic Psychiatry (Licence: WA MD61042709) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: AR E-10068) | |
| Enumeration Date | 2013-04-10 |
| Last Update Date | 2021-10-20 |