| NPI | 1780888586 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: ME MD19642) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: DE C7-0003766) |
| 207W00000X Ophthalmology (Licence: CT 049476) | |
| Enumeration Date | 2007-06-14 |
| Last Update Date | 2021-12-17 |