| NPI | 1346688421 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: OH 35.129607) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MT MED-PHYS-LIC-68781) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MA L-255574) | |
| Enumeration Date | 2013-06-11 |
| Last Update Date | 2019-05-04 |