| NPI | 1528565025 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: OH 34.014481) |
| Additional Taxonomies | 2084A0401X Psychiatry & Neurology Addiction Medicine (Licence: OH 34.014481) |
| 2084P0805X Psychiatry & Neurology Geriatric Psychiatry (Licence: OH 34.014481) | |
| Enumeration Date | 2018-04-11 |
| Last Update Date | 2024-06-10 |