| NPI | 1336335256 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0600X (Licence: GA 70809) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NE 28204) |
| 207WX0109X Ophthalmology, Neuro-ophthalmology (Licence: GA 70809) | |
| 207WX0109X Ophthalmology, Neuro-ophthalmology (Licence: NE 28204) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: GA 70809) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: NE 28204) | |
| Enumeration Date | 2007-09-25 |
| Last Update Date | 2024-04-08 |