| NPI | 1518145143 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CO DR.0058484) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: OH 35.095938) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: OH 57013048) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: WY 8687a) | |
| Enumeration Date | 2008-02-06 |
| Last Update Date | 2022-12-22 |