| NPI | 1013921618 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MS 12649) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: IA 20824) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: IA 20824) | |
| Enumeration Date | 2006-07-28 |
| Last Update Date | 2024-04-16 |