| NPI | 1447602362 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: OR MD210215) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: RI LP03810) |
| 207W00000X Ophthalmology (Licence: OR MD210215) | |
| 207Y00000X Otolaryngology (Licence: MI 4301502082) | |
| Enumeration Date | 2016-07-02 |
| Last Update Date | 2022-07-11 |