| NPI | 1265962872 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207WX0109X Ophthalmology, Neuro-ophthalmology (Licence: NY 307714) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: RI LP04092) |
| Enumeration Date | 2017-06-15 |
| Last Update Date | 2023-07-24 |