| NPI | 1861503591 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: OH 35-061694) |
| Additional Taxonomies | 2084F0202X Psychiatry & Neurology, Forensic Psychiatry (Licence: OH 61694) |
| 2084F0202X Psychiatry & Neurology, Forensic Psychiatry (Licence: OH 35-061694) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: OH 61694) | |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2022-06-15 |