| NPI | 1679520605 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: MO 2005019369) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MO 2005019369) |
| 207R00000X Internal Medicine (Licence: MO 2005019369) | |
| Enumeration Date | 2006-05-27 |
| Last Update Date | 2021-01-19 |