| NPI | 1710967435 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: OH 35100036) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: CA A33710) |
| 2084P0805X Psychiatry & Neurology Geriatric Psychiatry (Licence: OH 35100036) | |
| 2084P0805X Psychiatry & Neurology Geriatric Psychiatry (Licence: CA A33710) | |
| Enumeration Date | 2006-01-19 |
| Last Update Date | 2007-07-08 |