| NPI | 1841275591 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: OH 35-076993) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35-076993) |
| 207R00000X Internal Medicine (Licence: AK 6972) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA C187173) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: AK 6972) | |
| Enumeration Date | 2005-12-14 |
| Last Update Date | 2023-09-19 |