| NPI | 1407417363 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: GA 96206) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IA R-11668) |
| 207W00000X Ophthalmology (Licence: IA R-11668) | |
| Enumeration Date | 2019-06-21 |
| Last Update Date | 2024-04-29 |