| NPI | 1750841318 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: OH 35.148735) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 324381) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: PA MD481884) | |
| Enumeration Date | 2019-03-20 |
| Last Update Date | 2025-04-15 |