| NPI | 1851035083 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: MO 2026028247) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO 2022020765) |
| Enumeration Date | 2022-04-25 |
| Last Update Date | 2026-08-26 |