| NPI | 1811519358 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: TX BP10070769) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX BP10070769) |
| Enumeration Date | 2020-05-07 |
| Last Update Date | 2024-02-19 |