| NPI | 1780245266 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: TX U1695) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO 2019022801) |
| 207W00000X Ophthalmology (Licence: MO 2020012123) | |
| Enumeration Date | 2019-06-25 |
| Last Update Date | 2023-05-09 |