| NPI | 1013956085 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: MO 2002023847) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: KS 04-29858) |
| Enumeration Date | 2006-06-05 |
| Last Update Date | 2023-01-24 |