| NPI | 1952895484 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: OR MD209329) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125.072528) |
| Enumeration Date | 2018-06-18 |
| Last Update Date | 2023-08-08 |