| NPI | 1811081334 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0805X Psychiatry & Neurology, Geriatric Psychiatry (Licence: OH 35-068271) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: KY 36592) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: OH 35-068271) | |
| 2084P0805X Psychiatry & Neurology, Geriatric Psychiatry (Licence: KY 36592) | |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2022-01-27 |