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 | 2024-11-07 |