| NPI | 1851363824 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0805X (Licence: OH 35052584) |
| Additional Taxonomies | 2084F0202X Psychiatry & Neurology, Forensic Psychiatry (Licence: OH 35052584) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: OH 35 052584) | |
| Enumeration Date | 2006-02-03 |
| Last Update Date | 2020-12-07 |