NPI | 1801843024 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: OH 35.146058) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: KY 36010) |
Enumeration Date | 2006-05-31 |
Last Update Date | 2023-02-20 |