| NPI | 1477874683 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: GA 72589) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: GA 4208) |
| Enumeration Date | 2010-06-22 |
| Last Update Date | 2023-12-20 |