| NPI | 1639268444 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: VA 0101041202) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: VA 0101041202) |
| Enumeration Date | 2006-10-11 |
| Last Update Date | 2023-11-13 |