| NPI | 1689057135 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: SD 12043) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NE 7528) |
| 207W00000X Ophthalmology (Licence: SC 82443) | |
| Enumeration Date | 2015-07-01 |
| Last Update Date | 2022-06-28 |