| NPI | 1326676552 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: MN 69678) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 30748) |
| Enumeration Date | 2020-04-01 |
| Last Update Date | 2021-07-21 |