| NPI | 1588824494 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: CA A 118736) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ 70473) |
| Enumeration Date | 2008-06-13 |
| Last Update Date | 2013-12-16 |