| NPI | 1700370442 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: CA A177955) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 276297) |
| Enumeration Date | 2018-06-17 |
| Last Update Date | 2022-08-25 |