| NPI | 1184683799 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NC 9900134) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: OH 35-051448) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MD D0035081) | |
| Enumeration Date | 2006-03-22 |
| Last Update Date | 2022-12-19 |