| NPI | 1972738458 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: SC 39071) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: OH 57.015000) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: SC 39071) | |
| Enumeration Date | 2009-05-27 |
| Last Update Date | 2016-04-18 |