| NPI | 1891848263 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: WA MD00019369) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: CA MD00019369) |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: WA MD00019369) | |
| Enumeration Date | 2007-01-19 |
| Last Update Date | 2021-04-28 |