| NPI | 1194127464 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: AZ 64129) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: AZ 64129) |
| 207WX0109X Ophthalmology Neuro-ophthalmology (Licence: AZ 64129) | |
| Enumeration Date | 2014-09-18 |
| Last Update Date | 2023-03-14 |