| NPI | 1750724886 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IN 01078668A) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: OH 35129032) |
| Enumeration Date | 2013-04-08 |
| Last Update Date | 2022-09-09 |