| NPI | 1841359031 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0802X Psychiatry & Neurology Addiction Psychiatry (Licence: OH 35058370) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: OH 35058370) |
| Enumeration Date | 2006-12-06 |
| Last Update Date | 2009-06-26 |