| NPI | 1821219841 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: OH 35.097391) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: OH 35-097391) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MN 50916) | |
| 2084S0012X Psychiatry & Neurology, Sleep Medicine (Licence: OH 35.097391) | |
| Enumeration Date | 2007-05-01 |
| Last Update Date | 2020-09-14 |