| NPI | 1972548113 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: OH 35.076623) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: IN 01061155A) |
| 2084P0805X Psychiatry & Neurology Geriatric Psychiatry (Licence: IN 01061155A) | |
| 2084P0805X Psychiatry & Neurology Geriatric Psychiatry (Licence: OH 35.076623) | |
| Enumeration Date | 2006-06-20 |
| Last Update Date | 2007-07-08 |