| NPI | 1942943477 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: MI 4301511569) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301511569) |
| Enumeration Date | 2022-04-13 |
| Last Update Date | 2024-05-13 |