| NPI | 1972678894 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: OH 35-04-1394-b) |
| Additional Taxonomies | 2084A0401X Psychiatry & Neurology, Addiction Medicine (Licence: OH 35-04-1394-b) |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: OH 35-04-1394-b) | |
| Enumeration Date | 2006-11-24 |
| Last Update Date | 2013-03-04 |