| NPI | 1750366530 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAE-AHN THOMAS LEE Md 419-227-5176 |
| Organization Subpart ? | No |
| 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 | 2005-12-14 |
| Last Update Date | 2007-10-30 |