| NPI | 1669409694 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: WA MD00028617) |
| Additional Taxonomies | 207WX0109X Ophthalmology, Neuro-ophthalmology (Licence: WA MD00028617) |
| Enumeration Date | 2006-06-26 |
| Last Update Date | 2021-05-25 |