| NPI | 1164427738 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084A0401X Psychiatry & Neurology, Addiction Medicine (Licence: WI 29341) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: WI 29341) |
| 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: WI 29341) | |
| Enumeration Date | 2005-06-20 |
| Last Update Date | 2023-03-07 |