| NPI | 1912955063 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: WA MD60081780) |
| Additional Taxonomies | 174400000X Specialist (Licence: AR C5267) |
| 174400000X Specialist (Licence: WA MD60081780) | |
| 2084S0012X Psychiatry & Neurology, Sleep Medicine (Licence: WA MD60081780) | |
| Enumeration Date | 2006-05-04 |
| Last Update Date | 2011-11-18 |