| NPI | 1902090707 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MD D50293) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MD D50293) |
| 207W00000X Ophthalmology (Licence: MD D50293) | |
| Enumeration Date | 2007-09-05 |
| Last Update Date | 2021-05-30 |