| NPI | 1912943234 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: SC 17091) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: SC 17091) |
| Enumeration Date | 2006-06-22 |
| Last Update Date | 2020-10-20 |