| NPI | 1083741961 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: MO 2019042323) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: KS 04-35404) |
| 207WX0109X Ophthalmology Neuro-ophthalmology (Licence: AZ 28419) | |
| 207YX0901X Otolaryngology Otology & Neurotology (Licence: KS 04-35404) | |
| 2084N0400X Psychiatry & Neurology Neurology (Licence: KS 04-35404) | |
| 2084P2900X Psychiatry & Neurology Pain Medicine (Licence: AZ 28419) | |
| Enumeration Date | 2007-02-27 |
| Last Update Date | 2022-01-27 |