| NPI | 1508889403 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: TX M4392) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX M4392) |
| 208M00000X Hospitalist (Licence: TX M4392) | |
| 207WX0107X Ophthalmology, Retina Specialist (Licence: TX M4392) | |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2017-04-25 |