| NPI | 1104023308 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0109X Ophthalmology, Neuro-ophthalmology (Licence: FL ME128272) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: FL ME128272) |
| 207W00000X Ophthalmology (Licence: GA 66311) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: GA 66311) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME128272) | |
| Enumeration Date | 2007-06-29 |
| Last Update Date | 2022-10-25 |