| NPI | 1427337534 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: OH 35.143982) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: WV 26801) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: ND RL 11899) | |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: WV 26801) | |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: MN 57779) | |
| Enumeration Date | 2011-08-07 |
| Last Update Date | 2025-02-20 |