| NPI | 1144758319 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: OH 34.013676) |
| Additional Taxonomies | 2084F0202X Psychiatry & Neurology Forensic Psychiatry (Licence: OH 34.013676) |
| Enumeration Date | 2017-05-31 |
| Last Update Date | 2022-07-27 |