| NPI | 1295387934 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CA A186326) |
| Additional Taxonomies | 207WX0109X Ophthalmology, Neuro-ophthalmology (Licence: CA 186326) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: VA 0116032538) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: VA 0116032538) | |
| Enumeration Date | 2019-07-12 |
| Last Update Date | 2023-10-09 |