| NPI | 1548815681 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: PR 24642) |
| Additional Taxonomies | 207WX0109X Ophthalmology, Neuro-ophthalmology (Licence: PR 24642) |
| Enumeration Date | 2019-08-06 |
| Last Update Date | 2025-11-13 |