NPI | 1285080523 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: OH 34.013568) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: VA 0102205665) |
2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: VA 0102205665) | |
Enumeration Date | 2016-05-05 |
Last Update Date | 2021-09-02 |