| NPI | 1013531045 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: SC 84316) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: SC LL84316) |
| Enumeration Date | 2020-06-05 |
| Last Update Date | 2024-06-18 |