| NPI | 1710101977 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: AR E7828) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KY 44011) |
| 207W00000X Ophthalmology (Licence: TN 48307) | |
| 207W00000X Ophthalmology (Licence: KY 44011) | |
| Enumeration Date | 2007-04-12 |
| Last Update Date | 2020-11-12 |