| NPI | 1073791950 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0200X Internal Medicine Critical Care Medicine (Licence: FL ME 104282) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: FL ME104282) |
| Enumeration Date | 2008-02-04 |
| Last Update Date | 2018-03-17 |