| NPI | 1942318290 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: OH 092117) |
| Additional Taxonomies | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: WV 16873) |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: KY 25933) | |
| Enumeration Date | 2006-08-28 |
| Last Update Date | 2008-08-25 |