| NPI | 1275020836 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: WI 81408-20) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 29273) |
| 207W00000X Ophthalmology (Licence: MN 65796) | |
| Enumeration Date | 2018-04-19 |
| Last Update Date | 2024-01-10 |