| NPI | 1053321604 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME53396) |
| Additional Taxonomies | 207WX0109X Ophthalmology, Neuro-ophthalmology (Licence: FL ME53396) |
| Enumeration Date | 2006-08-08 |
| Last Update Date | 2023-09-12 |