| NPI | 1841485364 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207WX0109X Ophthalmology, Neuro-ophthalmology (Licence: NY 259239) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NY 259239) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MA 249153) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: NY 259239) | |
| Enumeration Date | 2007-09-07 |
| Last Update Date | 2023-06-22 |