| NPI | 1619268224 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0200X Ophthalmology, Ophthalmic Plastic and Reconstructive Surgery (Licence: PA MD460570) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT198962) |
| Enumeration Date | 2011-04-29 |
| Last Update Date | 2022-07-21 |