| NPI | 1831184720 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: OH 35.076784) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: UT 278413-1205) |
| 2084F0202X Psychiatry & Neurology, Forensic Psychiatry (Licence: OH 35076784) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: OH 35076784) | |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: OH 35076784) | |
| 2084F0202X Psychiatry & Neurology, Forensic Psychiatry (Licence: OH 35.076784) | |
| Enumeration Date | 2005-09-16 |
| Last Update Date | 2025-06-16 |