| NPI | 1235491994 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: UT 11678583-1205) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NM MD2016-0492) |
| 207R00000X Internal Medicine (Licence: AZ R73211) | |
| Enumeration Date | 2012-06-08 |
| Last Update Date | 2024-01-25 |