| NPI | 1982693867 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: OH 35.093323) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: MT 10642) |
| Enumeration Date | 2005-10-13 |
| Last Update Date | 2023-03-07 |