| 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 |