| NPI | 1740489632 |
|---|---|
| Former Name | JEFFREY LODGE ALEXANDER |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: OH 35089921) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: OH 35.089921) |
| Enumeration Date | 2007-07-12 |
| Last Update Date | 2009-03-30 |