| NPI | 1013445410 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NC 2021-00424) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: AZ R76154) |
| Enumeration Date | 2017-05-30 |
| Last Update Date | 2024-07-18 |