| NPI | 1922529536 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: MO 2022035535) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KS 94-09368) |
| Enumeration Date | 2017-07-05 |
| Last Update Date | 2022-09-28 |