| NPI | 1609080886 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0109X Ophthalmology Neuro-ophthalmology (Licence: OR MD26999) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology Neurology (Licence: OR MD26999) |
| 2084N0400X Psychiatry & Neurology Neurology (Licence: UT 654661-1205) | |
| Enumeration Date | 2007-05-09 |
| Last Update Date | 2019-07-22 |