| NPI | 1932547734 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: MT MED-PHYS-LIC-93874) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: SC LL35856) |
| 207W00000X Ophthalmology (Licence: SC MD35856) | |
| Enumeration Date | 2013-06-13 |
| Last Update Date | 2025-04-10 |