| NPI | 1134481393 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: MO 2017024010) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NE 6748) |
| 207W00000X Ophthalmology (Licence: IN 02004847A) | |
| Enumeration Date | 2012-06-13 |
| Last Update Date | 2022-07-21 |