NPI | 1740869080 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207QA0401X Family Medicine, Addiction Medicine (Licence: OH 34.017621) |
Additional Taxonomies | 2084A0401X Psychiatry & Neurology, Addiction Medicine (Licence: OH 34.017621) |
Enumeration Date | 2021-04-05 |
Last Update Date | 2025-07-17 |