| NPI | 1417086356 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: OH 35.098356) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MD D70410) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MD P20997) | |
| Enumeration Date | 2007-03-05 |
| Last Update Date | 2023-10-21 |