| NPI | 1922539337 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084B0040X Psychiatry & Neurology, Behavioral Neurology & Neuropsychiatry (Licence: CA A170954) |
| Additional Taxonomies | 2084F0202X Psychiatry & Neurology, Forensic Psychiatry (Licence: MA 1016124) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: OH 35.134666) | |
| Enumeration Date | 2017-03-27 |
| Last Update Date | 2025-06-11 |