| NPI | 1891703500 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: MI 4301054843) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: MI 4301054843) |
| Enumeration Date | 2006-08-04 |
| Last Update Date | 2019-11-11 |