| NPI | 1679935829 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P2900X Psychiatry & Neurology, Pain Medicine (Licence: OH 35.135287) |
| Additional Taxonomies | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: OH 35.135287) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: OH 35.135287) | |
| Enumeration Date | 2016-03-27 |
| Last Update Date | 2022-06-17 |