| NPI | 1346450418 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA C39841) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: CA C38941) |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2021-05-18 |