| NPI | 1043370562 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: VA 0101055241) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: DC MD034337) |
| 207W00000X Ophthalmology (Licence: MD D46263) | |
| Enumeration Date | 2006-12-12 |
| Last Update Date | 2025-09-11 |