| NPI | 1275612848 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: OH 35.063012) |
| Additional Taxonomies | 2084S0012X Psychiatry & Neurology Sleep Medicine (Licence: OH 35.063012) |
| 2084P0802X Psychiatry & Neurology Addiction Psychiatry (Licence: OH 35.063012) | |
| Enumeration Date | 2006-11-03 |
| Last Update Date | 2018-06-14 |