NPI | 1982818431 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: OH 35.095403) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: OH 57 . 011675) |
2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TN 47980) | |
Enumeration Date | 2007-05-10 |
Last Update Date | 2015-05-05 |