| NPI | 1881261840 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: PA MD489119) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX BP10077053) |
| Enumeration Date | 2021-06-08 |
| Last Update Date | 2025-06-02 |