| NPI | 1326420183 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: GA 82968) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: GA 7644) |
| Enumeration Date | 2015-06-29 |
| Last Update Date | 2019-05-15 |