| NPI | 1497249940 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: MI 1497249940) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301114597) |
| Enumeration Date | 2018-06-19 |
| Last Update Date | 2019-06-07 |