| NPI | 1235968413 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: OH LE-00052811)  | 
| Additional Taxonomies | 2084P0005X Psychiatry & Neurology, Neurodevelopmental Disabilities (Licence: OH LE-00052811)  | 
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: OH LE-00052811)  | |
| Enumeration Date | 2024-07-29 | 
| Last Update Date | 2024-07-29 |