NPI | 1467839415 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: OH 34.013900) |
Additional Taxonomies | 2084A0401X Psychiatry & Neurology, Addiction Medicine (Licence: OH 34.013900) |
Enumeration Date | 2015-04-29 |
Last Update Date | 2019-07-16 |