| NPI | 1427269042 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: KY 46802) |
| Additional Taxonomies | 2084A0401X Psychiatry & Neurology, Addiction Medicine (Licence: KY 46802) |
| 2084P0015X Psychiatry & Neurology, Psychosomatic Medicine (Licence: KY 46802) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: OH 35.090679) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: VA 0101255726) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MD D0076916) | |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: MD D0076916) | |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: KY 46802) | |
| Enumeration Date | 2007-05-25 |
| Last Update Date | 2022-03-29 |