| NPI | 1679678320 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083A0300X Preventive Medicine, Addiction Medicine (Licence: FL ME58997) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: FL me58997) |
| Enumeration Date | 2006-09-14 |
| Last Update Date | 2020-09-07 |