| NPI | 1114001310 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: OH 35.032638) |
| Additional Taxonomies | 2084S0012X Psychiatry & Neurology Sleep Medicine (Licence: OH 35.032638) |
| Enumeration Date | 2006-10-24 |
| Last Update Date | 2017-03-10 |