| NPI | 1053460691 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P2900X Psychiatry & Neurology, Pain Medicine (Licence: OH 35-07-8534 S) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: OH 35-07-8534 S) |
| Enumeration Date | 2007-01-10 |
| Last Update Date | 2007-07-20 |