| NPI | 1295746352 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: OH 35.089022) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MI 4301076100) |
| 2084P0805X Psychiatry & Neurology, Geriatric Psychiatry (Licence: MI 4301076100) | |
| Enumeration Date | 2006-08-11 |
| Last Update Date | 2010-04-13 |