| NPI | 1508846536 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: OH 35-061446) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: OH 35-061446) |
| 2084P0805X Psychiatry & Neurology, Geriatric Psychiatry (Licence: OH 35-061446) | |
| Enumeration Date | 2006-01-17 |
| Last Update Date | 2014-06-18 |