| NPI | 1023425832 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: MA 292586) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: MA 259334) |
| Enumeration Date | 2014-07-14 |
| Last Update Date | 2022-07-28 |