| NPI | 1578592952 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: OH 35 079196) |
| Additional Taxonomies | 2084P0805X (Licence: OH 35079196) |
| Enumeration Date | 2006-06-30 |
| Last Update Date | 2018-01-29 |