| NPI | 1235750670 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: TX v0816) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ R78055) |
| 207W00000X Ophthalmology (Licence: AZ R78055) | |
| Enumeration Date | 2020-04-27 |
| Last Update Date | 2024-04-27 |