| NPI | 1992233662 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: WI 74751) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ R76147) |
| Enumeration Date | 2017-05-25 |
| Last Update Date | 2022-03-23 |