| NPI | 1578534228 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: VA 01012238406) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 01012238406) |
| Enumeration Date | 2006-01-31 |
| Last Update Date | 2022-11-28 |