| NPI | 1457732661 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: CA A180518) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 264271) |
| Enumeration Date | 2015-06-12 |
| Last Update Date | 2025-04-07 |