| NPI | 1356832125 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: CO DR.0068664) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ R76839) |
| Enumeration Date | 2018-05-28 |
| Last Update Date | 2022-09-16 |