| NPI | 1306888771 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: OH 34-00-5024-4) |
| Additional Taxonomies | 2084P0802X Psychiatry & Neurology, Addiction Psychiatry (Licence: OH 34-00-5024-4) |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: OH 34-00-5024-4) | |
| 2084P0805X (Licence: OH 34-00-5024-4) | |
| Enumeration Date | 2006-06-12 |
| Last Update Date | 2011-12-08 |