| NPI | 1841412418 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084F0202X Psychiatry & Neurology, Forensic Psychiatry (Licence: OH 34010148) |
| Additional Taxonomies | 2084F0202X Psychiatry & Neurology, Forensic Psychiatry (Licence: MI 5101017874) |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2015-02-03 |