| NPI | 1629220512 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: GA 73923) |
| Additional Taxonomies | 207WX0109X Ophthalmology, Neuro-ophthalmology (Licence: GA 73923) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: GA 073923) | |
| Enumeration Date | 2008-10-22 |
| Last Update Date | 2024-04-23 |