| NPI | 1003965294 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: OH 35-05-9121) |
| Additional Taxonomies | 2084F0202X Psychiatry & Neurology, Forensic Psychiatry (Licence: OH 35-05-9121) |
| 2084P0805X Psychiatry & Neurology, Geriatric Psychiatry (Licence: OH 35-05-9121) | |
| Enumeration Date | 2007-01-09 |
| Last Update Date | 2013-11-21 |