| NPI | 1477114098 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: ND 19679) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: ND RL15832) |
| Enumeration Date | 2019-06-25 |
| Last Update Date | 2023-09-27 |