| NPI | 1891929618 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NC 2013-01244) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125055718) |
| Enumeration Date | 2009-05-07 |
| Last Update Date | 2021-04-20 |