| NPI | 1114004991 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: OH 35.093695) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: SC 27047) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: OH 35.093695) | |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2009-06-24 |