| NPI | 1447462353 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: WA MD60170184) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 57011825) |
| 207W00000X Ophthalmology (Licence: MI 43010958228) | |
| Enumeration Date | 2007-05-04 |
| Last Update Date | 2020-08-13 |