| NPI | 1467537985 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: OH OH35032441) |
| Additional Taxonomies | 2084A0401X Psychiatry & Neurology, Addiction Medicine (Licence: OH OH35032441) |
| 2084P0805X (Licence: OH OH35032441) | |
| Enumeration Date | 2006-10-25 |
| Last Update Date | 2012-03-20 |