| NPI | 1093100901 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: OH 35.142770)  | 
| Enumeration Date | 2015-03-30 | 
| Last Update Date | 2021-07-14 |