| NPI | 1871889147 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: OH 35.122532) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: OH 35.122532) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: OH 35.122532) | |
| Enumeration Date | 2011-06-24 |
| Last Update Date | 2023-10-11 |