| NPI | 1164650263 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NC 2013-00696) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 157173) |
| Enumeration Date | 2009-06-26 |
| Last Update Date | 2019-10-01 |