| NPI | 1932111846 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: WA MD00048704) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: WA ML20008501) |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: WA MD00048704) | |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: ID M-10990) | |
| Enumeration Date | 2006-08-12 |
| Last Update Date | 2018-03-20 |