| NPI | 1093723496 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: OH 35.090717) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IN 01043583A) |
| 2084P0802X Psychiatry & Neurology, Addiction Psychiatry (Licence: IN 01043583A) | |
| 2084P0805X Psychiatry & Neurology, Geriatric Psychiatry (Licence: IN 01043583A) | |
| Enumeration Date | 2006-08-03 |
| Last Update Date | 2021-02-25 |