| NPI | 1306282389 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: AZ 55634) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ R73779) |
| 207W00000X Ophthalmology (Licence: CA A148268) | |
| Enumeration Date | 2013-05-16 |
| Last Update Date | 2020-11-02 |