| NPI | 1083690382 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: OH 34007130) |
| Additional Taxonomies | 2084F0202X Psychiatry & Neurology Forensic Psychiatry (Licence: OH 34.007130) |
| Enumeration Date | 2005-12-19 |
| Last Update Date | 2018-04-16 |