| NPI | 1023454386 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: TX S0733) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: CT 1.056429) |
| Enumeration Date | 2013-05-14 |
| Last Update Date | 2022-12-19 |