| NPI | 1447550975 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: MT 41039) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ R71952) |
| Enumeration Date | 2010-11-01 |
| Last Update Date | 2016-09-29 |