| NPI | 1033108006 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: OH 35.060459) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: KY 28332) |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: KY 28332) | |
| Enumeration Date | 2005-10-20 |
| Last Update Date | 2014-09-09 |