| NPI | 1780663039 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: OH 35-06-1267-M) |
| Additional Taxonomies | 2084P0802X Psychiatry & Neurology Addiction Psychiatry (Licence: OH 35-06-1267-M) |
| Enumeration Date | 2006-01-14 |
| Last Update Date | 2007-07-08 |