| NPI | 1548297013 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: OH 35-039200) |
| Additional Taxonomies | 2084A0401X Psychiatry & Neurology, Addiction Medicine (Licence: OH 35-039200) |
| Enumeration Date | 2006-06-28 |
| Last Update Date | 2017-11-09 |