| NPI | 1720422520 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: GA 78032) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OK 29960) |
| Enumeration Date | 2013-04-23 |
| Last Update Date | 2018-03-23 |