| NPI | 1659535888 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: OH 34.010468) |
| Additional Taxonomies | 2084P0802X Psychiatry & Neurology, Addiction Psychiatry (Licence: OH 34.010468) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: OH 34.010468) | |
| Enumeration Date | 2008-07-16 |
| Last Update Date | 2013-09-13 |