| NPI | 1548432602 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: VT 042.0012692) |
| Additional Taxonomies | 207WX0109X Ophthalmology Neuro-ophthalmology (Licence: VT 042-0012692) |
| Enumeration Date | 2008-03-28 |
| Last Update Date | 2018-02-14 |