| NPI | 1497729834 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: GA 32147) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 200100327) |
| 207P00000X Emergency Medicine (Licence: GA 032147) | |
| Enumeration Date | 2006-02-14 |
| Last Update Date | 2018-05-28 |